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Physical Therapy as Effective as Surgery for Degenerative Rotator Cuff Shoulder Pain

Physical therapy treatment is as effective as surgery for the treatment of another condition. See our previous posts that describe how physical therapy treatment is as effective as surgery for low back pain caused by spinal stenosis and for knee pain caused by degenerative meniscus tears. In a 2014 study reported in the Journal of Bone and Joint Surgery physical therapy treatment of shoulder pain caused by non-traumatic tears was as effective as surgery. You will avoid unnecessary and time consuming appointments with medical doctors and potential side effects of unnecessary x-rays and medication if you consult a physical therapist first. Not to mention the money you will spend on the medical doctors and their tests and treatments.

The rotator cuff is the deepest layer of muscle in the shoulder joint. It controls the position and complex motion of the rounded upper end of the humerus, the upper arm bone, and the shallow cup on the side of the shoulder blade or scapula that is called the glenoid fossa. The rounded end of the humerus combined with the shallow cup on the shoulder blade allows for extensive motion of the shoulder. There is a “roof” overhanging the shoulder ball and socket formed by another part of the shoulder blade bone. In a normal shoulder the rotator cuff helps control movement of the ball on the socket to keep it from hitting the overhanging roof.

Shoulder pain is often caused by degenerative rotator cuff tears. For example weak muscles or poor flexibility combined with overuse can cause a tear. The tear disrupts the ability of the rotator cuff muscles to properly control the ball and socket joint allowing trauma of other parts of the rotator cuff or other shoulder joint tissues. This happens when the head of the humerus crashes into the overhanging roof or when excess force is transferred because of weakness or tightness. This causes more pain and disruption of the normal mechanical control of the shoulder joint and can lead to further rotator cuff tears or other degenerative injuries to the shoulder.

Physical therapy works by restoring muscle strength and flexibility of the shoulder joint and surrounding muscles and joints. The goal is to restore normal function of the rotator cuff or to build up other muscles to compensate for the tears and disrupt the downward spiral that causes shoulder pain. While physical therapy does not cause the rotator cuff tear to heal the result of physical therapy treatment is equal to that of a surgical repair. In the end physical therapy is an effective treatment for your shoulder pain without the risk, time and cost of surgery.



Christopher DiPasquale, PhD, PT, OCS, SCS, CHT is a physical therapist at Performance Physical Therapy & Sports Medicine with offices in Hebron and Colchester, Connecticut. He is board certified by the American Board of Physical Therapy Specialties in Orthopedic Physical Therapy and Sports Physical Therapy and a Certified Hand Therapist by the Hand Therapy Certification Committee.

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