Why you should look at conservative therapy for rotator cuff injuries before surgery

In many cases patients believe that surgery is the answer. “It’s broken, therefore it must be repaired” seems to be the logic. In some circumstances surgery is warrented however, the results are mixed and make me wonder why wouldn’t we want to try something else first? In developed countries shoulder pain is the third most common musculoskeletal complaint to general practitioners and 65-70% are estimated to be that of the rotator cuff origin.

So when it comes to rotator cuffs there is plenty of injuries to be found. Just in the US 10% of the population aged 60 and over have a chronic rotator cuff injury. That works out to be about 5.7 million people. In Australia alone rotator cuff surgeries have cost an estimated $250 million per year! That’s huge and honestly unnecessary.

But what IS the rotator cuff?

The rotator cuff consists of four primary muscles, suprspinatus, infraspinatus, tere’s minor and subscapularus. These four muscles work together to give your glenohumeral joint (shoulder joint) stability and optimal joint congruency throughout movement while also contributing to movement. Although the rotator cuff is comprised of four muscles the tendons of all four join and insert onto our humerus helping to provide stability working together as one tendon.

Typically patients are suggested to have surgery for damaged rotator cuffs which reattaches the tendon and increases the size of the subacromial space(where the tendons lie). Results do show satisfactory outcomes for pain and function and helps avoid secondary surgeries. However, when these patients are imaged again later in life 20-94% of them have shown recurrent damage to the repaired tendon.

With keeping this in mind, there is solid evidence to support conservative treatment such as manual therapy and rehabilitation of the shoulder for patients with chronic, acute, partial and full thickness tears dependant on age and demographic. Regardless when we look at the cost of surgical treatment and the rate of reoccurrence using conservative options to help treat the rotator cuff looks like an appealing and beneficial option.

If you have any queries please call 9905 9099 or visit www.neurohealthchiropractic.com.au

This article is written by Dr. Braeden Melmer, Chiropractor @ Neurohealth