by: Chad Madden
One of the most common questions we get asked is, can I heal my torn rotator cuff without surgery? Before we answer that question, it is important to know what exactly your rotator cuff actually is.
Your rotator cuff is composed of 4 different muscles. Each muscle spans from your shoulder blade, or Scapula, and runs to the top of your arm bone, or Humerus. There are three muscles that span that distance behind your Scapula and one muscle that is between your Scapula and rib cage. The name of the most commonly torn rotator cuff muscle is Supraspinatus. That muscle is located at a spot where a bony prominence, the acromion, and rub against it and lead to tears. When surgeons repair a torn rotator cuff, they actually shave down part of this bony prominence to increase the space. That space is referred to as the Subacromial Space.
How Does A Rotator Cuff Tear Begin?
Over time, most of the people we see in the clinic who have a torn rotator cuff have a condition called rotator cuff impingement. Common complaints we’ll hear are, “It hurts to reach behind my back” or “It wakes me up at night when I sleep”. The most common sleeping position of people with a torn rotator cuff is sleeping on their stomach. When you sleep on your stomach, one arm is generally raised over your head. This motion actually reduces the Subacromial Space and over time, can lead to tearing.
What physical therapy can do is work to open up that Subacromial Space and relieve the pressure on the joint. What we look to do is to decrease the pain and inflammation in that area by doing a series of gentle mobilizations and manipulations. In most cases, patients will get their full range of motion back with full strength in the shoulder. For you, the reader, you’re probably not interested in any of those things aside from the decrease in pain and getting back to the activities you used to do whether that’s getting dressed or reaching behind your back or some other activity without pain. The answer to the question of, “Can I heal my torn rotator cuff?” is yes, in some cases. For most people who have what’s called a Full-Thickness tear, it’s a little harder to heal without surgery. What we can do is strengthen all the muscles around the torn muscle to ensure they’re strong enough to compensate for the lack of movement from the torn muscle. Occasionally, surgery is needed…but most of the time, for about 90% of the normal rotator cuff tears, a good physical therapist will be able to alleviate most, if not all of the painful symptoms you’re experiencing.