Treating Full-Thickness Rotator Cuff Tears Nonoperatively

#197: On this episode of the #AskMikeReinold show we talk about working with patients with full-thickness rotator cuff tears, some of the treatments we would focus on for those trying nonoperative physical therapy, and if they can even avoid surgery at all. To subscribe and ask your questions, go to MikeReinold.com/askmikereinold/.
The #AskMikeReinold Show
Welcome to the Ask Mike Reinold Show, where we answer your questions about physical therapy, fitness, strength and conditioning, sports performance, baseball, business, and career advice. Join myself, Lenny Macrina, and my team at Champion Physical Therapy and Performance in Boston, MA and learn how we help people feel better, move better, and perform better. Ask your questions at MikeReinold.com/askmikereinold/ and follow us at @mikereinold, @lenmacpt, and @championptp.
👊🏻Was this helpful? Subscribe to my KZbin channel for more performance therapy and training tips!
🤔Have a question/comment? Drop a note below in the comment section and let me know!
*****
🧠 WANT TO LEARN MORE FROM ME? Get my latest content & FREE presentation on how to get started with functional performance therapy and training:
bit.ly/performance-therapy-and...
*****
💪WANT TO TRAIN WITH CHAMPION? Click here to learn more about our online and in-person training programs:
championptandperformance.com/...
*****
👋 FOLLOW ME ONLINE:
Instagram: mikereinold
Facebook: mikereinold.pt
Twitter: mikereinold
Blog: mikereinold.com/blog/

[@harirawat3515]

I was having severe pain in my right shoulder due to fall and numbness in whole right hand right from collor bone. On MRI it was reported a full thick tear in supraspinatus rotator cuff. Doctor recommended orthoscopic surgery. Another doctor recommended for IA injection in right shoulder 6 times after interval of 3 weeks. I got one shot. Later I visited HOD and professor of orthopaedic surgery who after clinically examining by testing certain movements and said there's no need of surgery as I am clinically fit. He recommended for physiotherapy and hot fermentation. He also recommended for internal rotation+external rotation and abduction (lateral raise) exercises for strengthening shoulder muscles. I am also doing dead hanging for 30 seconds 2/3 times regularly. I don't have any pain and regained shoulder strength also.

[@oldducky]

Thanks! I fell April 2020, dislocated shoulder have 2 partial thickness and one full thickness ligament tears. I am a senior citizen and didn't have surgery. Have a great physical therapist who I see twice a week. Big improvement in pain level, mobility and strength. Exercises are preventing frozen shoulder. I have always been physically active so I hope I can get back to "normal" while being cautious. I wish I had known better body mechanics when I was working in assembly factories, and doing manual labor. I would have treated my body better before my warranty expired!

[@louiseboyd8896]

Thank you so much for posting this video....I have a full tear rotator cuff and am making progress with pt...and age 74 and in good shape....progress is gradually, but working.

[@TommyJohn1]

Summary of RTC fix without surgery - alleviate their pain - achieve motion: arom/prom - isolated strengthening of the cuff muscles - functional strengthening of the cuff/shoulder - re-assess performance, review MRI if needed

[@alwayshumble8817]

So what are some exercise would recommend.

[@drumcrazd]

Hi guys.....I have a full-thickness non repairable retracted tear in the top muscle of my rotator cuff.....I'm 63 years old.....injury was 6 months ago and can only lift my arm just to perpendicular to my body with the shoulder shrug......I was told my only options are a complete shoulder replacement or physio.....can you direct me to exercises on video I should be doing please?

[@ketanhulawale3319]

Great vid bro

[@jimc3891]

I have had prp treatment for full thickness tears without surgery. And for other grades of tears. I recently did prp for a fully torn bicep, large subscapularis tear along with other rotator cuff abnormalities. Fortunately I have always been active (71 years old) and never lost too much range of motion in either shoulder, both heavily impacted by trauma throughout the years. I believe the prp “healed” the inflamed and or injured tendons reduced inflammation overall in the rotator cuff allowing “healing and rebuilding” muscle mass and allowing various remaining tissues to learn to work together to allow me carry on a normal, but very active life. Right now rest is key (prp last Friday) if I want functional movement in the future.

[@HeyIntegrity]

how long did it take to heal?

[@ljpphel826]

How does prp reattach the tendon your arm bone ?my tendon was tore from my arm bonr

[@kathysavage2548]

I have rotator and labrum tear with moderate pain. Dr. Wants to do surgery. I just had my other shoulder done with same issues and the recovery is long. Starting to think of not doing the other shoulder.

[@purcelldasher3969]

PT made my full thickness tear much worse….My 1st MRI (without contrast) showed a partial tear….When I had my 2nd MRI (with contrast) showed a torn labrum and bicep tendon….I told my PT it was painful doing the exercises and he didn’t believe me and he made it worse….Make a long story short….I HAD TO HAVE A REPAIR OF A 99% TORN ROTATOR CUFF WHICH TO BE FIXED NON-ARTHSCOPIC…..They had to open my shoulder up

[@XjtBA]

Was your surgery a success? I have full thickness tear.

[@nahuwoldemariam3865]

I just got my MRI report and it looks like I have a full thickness tear of my supraspinatus tendon. I was really hoping to avoid surgery.

[@shawnmaloney6845]

I just got the same diagnosis and measuring 1cm. Also trying to avoid surgery. How are you doing? Any suggestions?

[@magsteel9891]

The problem with this question about percentage of people with a full thickness tear heal non-operatively is you wouldn't know if it was full thickness unless they had an MRI. If they are in pain and they come in for PT and feel better they would never know if it was full, partial, or just inflamed.

[@johnnycroat]

radiologist would not be able to identify full tear on Ultrasound or xray? only MRI can confirm?

[@XjtBA]

@@johnnycroat yes, I had both x rays and MRI and the MRI found I had a full thickness rotator cuff tear

[@Haley17thomas]

can chiropractic help my tear, been doing PT for 4 months. I'm 68 don't really want surgery. getting stronger have almost full range of motion..

[@yasim9435]

The case when people having asymptomatic Supraspinatus tear go to doctor is when they get additional injury like proximal biceps tendon tear and then MRI reveal prior rotator cuff tendon tear. Does this mean that torn Supraspinatus tendon causes other injuries ? In such case how could non-surgical treatment be effective ? Can your treatment return athletes like tennis players back to the game at the same level as before tear occurred?

[@ErinM-2024]

I was just diagnosed with mild tendinosis In the supraspinatus and infraspinatus. I have popping in the side of my shoulder/upper arm and in the back of my shoulder like when I’m doing the painful arc sign. As I’m coming down, my shoulder pops. It doesn’t hurt but it feels like it’s catching. Then in the back of my shoulder when I’m getting ready to throw the ball for my dog and I reach back

[@wendell3519]

My name is Wendell Barnes I cannot raise my arm I've had two surgeries they say I have a full thickness tear again what does it do

[@wendell3519]

Hey Mike bad shoulder surgery December 29th 2022 evidently I told my shoulder up I had surgery February 23rd they're telling me I still have a full thickness tear I cannot raise my arm help tell me something

[@greggorybouchard2671]

Suspension bridge concept gave me more hope. Thank u.

[@janewilder7490]

I am so screwed. I am 73. I have so much pain. I have massive tears complete. infraspinitis and supraspinitis, traumatic. They won't do surgery on me , its too bad despite my perfect ROM

[@tobiasjacobson5655]

welcome fernando !

[@dougschmidt5132]

5 to 90 % retear there cuff after surgery ? My personal experience is I have been in construction my whole career and due to repetitive deterioration I have had both soldiers repaired in my 50s . I am now 66 and looking back that was the best decision for me. But that stat you threw out blows me away. Never heard that before.

[@breakthroughvison]

Hi you really think full tear can be fix like that no surgery ?

[@lauridancer1]

Honestly, I’m really looking for some solid advice and people normally don’t have time to just listen to banter and goofing around so I’ll pass on this video the videos that I will listen to or the ones it gets straight to the answers of my question which is can you heal a rotator cuff tear full thickness?

[@FiredUpDanceFitness]

I have full thickness tears in Supraspinatis, infraspinatis, subscapularis. According to my ortho, surgical repair is not helpful. I'm pretty functional with pain in certain movements. I have been a fitness professional for 40 years and still teach 6 plus movement classes per week. The worry is that I will dislocate my shoulder. Yikes. My ortho said that a reverse replacement is the only thing that would help me if I become non-functional. No push-ups for me or planks and I avoid dumb bell use. But I'm hopeful I can avoid surgery -EVER! Do you agree? Strategy?

[@maggiewagmore8778]

Why did your ortho advise that surgery would not help? How much time has passed since your injury?

[@evelinayounan8090]

How did you healing went? I have full lenght superspiatus tear and I am going to wait....as long as it will take

[@Mikee535]

@@evelinayounan8090 how have you done with avoiding surgery? Thanks. Been 7 mo. since my fall and Im not sure about surgery.

[@evelinayounan8090]

@@Mikee535 it will heal naturally...tendons heal and much faster than internet says..i had a tendonitis on my torn tendons...everything heals...freaking out will bring more problems...now i m having anal cancer scare that doctors added other risk factor - steroid topical creams

[@JayTalksinjury]

Nov 9 my partial tear was turned into a full supraspinatus 9mm tear non operable with stage 1 frozen shoulder from chiro adjust. I've basically broken up and shoulder moving. 53 yrs old an same body as 18 just added cpl breaks that all healed fine . If you don't fix the supraspinatus how well has your outcomes been ? Mine has retracted.. i am Trucker and a bike rider . I need to do 20 push ups in a physical for work .. possible ?.i see a surgeon jan 2 2024 . I'm 5 10 175 lbs an fitish now. Appreciate happy holidays

[@JayTalksinjury]

While waiting for surgeon appointment next Tues another tore ... long road but not giving up.

[@paulsilva6543]

Sir im in the same boat. What did you do?Could you do the push ups? have you been able to maintain your employment without the surgery? I need some hope

[@jamesficaro4332]

I have a partial tear in my infraspinatus and orthopedic wants to do surgery. U think rehab is better and sufficient

[@Mikee535]

In 2017 I had a partial tear that healed on its own. Foot and Ankle surgeon friend said give it a year if you can and it did heal. I had another fall 7 months ago and have a full tear now. Deciding what to do. But yes the partial tear healed on its own I did not do any PT.

[@tanyagrimes1668]

I have three tears in my rotator cuff. Two full thickness ones and another medium one with a fracture to the top of the shoulder that was not caught two years ago when I fell and broke my arm about 3 inches from the elbow up. After my arm healed I had the pain in my muscle and went back to the doctor and he told me it was a rotor cup tear and gave me a quarter shot. This past year when we go down to Florida every winter I let my pain management doctor now because I have plenty of other things wrong with me also know about the pain in my arm getting much worse and he did an MRI and found out about the three rotor cup tears and gave me A amniotic fluid shot to be able to go stem cells and it did not work. I’m waiting to go to my doctor next Wednesday to see what they are going to do I’m sure that I am in for surgery. I am in a lot of pain. My problem is in my other arm I do not have a bone in my shoulder or upper arm from a fall back in 2009 and I’m very scared of what to do or how I’m going to be able to not have an arm to use. Any suggestions

[@ki8417]

How are you now

[@geogeo4139]

I just had surgery for full Rotator cuff tear 3 weeks ago. I have a sling. Small improvement in past 3 weeks since surgery. I am concerned doh. I hope to reach 100% in 9 months. Can you tell me how are you doing? How long did you have pain after surgery?

[@GoodByeSkyHarborLive]

@@geogeo4139 Which RC muscles do you have the tear in? Which pain doc did you go to, i live in FL. Was he willing to give you opiods?

[@geogeo4139]

@@GoodByeSkyHarborLive Right shoulder! I am in San Francisco. Dr gave me oxycodone 30 pills. Only used about 10. It was the surgery Dr. that got me the medication. Kaiser!

[@SanSav77]

I have abnormal echotexture in keeping with partial thickness intrasubstance tear of the infraspinatus. The tear measures 8 mm in length and 2.7 mm in width involving 20% of thickness of the tendon. Will a cortisone injection help?

[@ArunV32]

Hi how are you now? Have you done surgery

[@Rashidharoonkhan]

Dear sir This is my MRI report partial thickness tear 30% of distal supraspinatus tendon involving the anterior articular fibers Kindly advise It will heal without surgery And how much time take Thanks

[@ArunV32]

Hi how are you friend now same problem me.

[@Rashidharoonkhan]

@@ArunV32 don't move your hand for next 20 days.. It will be fixed automatically..just like mine. If u move your hand.. it will increase..

[@ArunV32]

@@Rashidharoonkhan Thank you so much for your reply.

[@ArunV32]

Can u share your no plz if possiable.

[@HeyIntegrity]

@@Rashidharoonkhan what do you mean don't move your hand? Like which movement did you not do

[@evelinayounan8090]

I have full lengh superspatiatus tear. My shoulder hurts, but manageable...i decided do not undergo surgery

[@Mikee535]

how have you been doing? Im in the same boat with full ROM, I fell down the stairs Oct 7 2023. Don't know if I should get surgery. Thanks

[@paulenej5839]

I have a full tear in my rotor cuff. Should i be exercising or resting it. They want to do surgery but can't get me in till march next year. Is there anything you can suggest. Thanking you

[@paladindanse98]

PT 3 days per week. External, internal rotations, strengthen the traps, rear delts, biceps, rotator cuffs. Avoid surgery if at all possible.

[@roscoepike9838]

What else you going to do? I’m getting cut on next week. Complete tear

[@ljpphel826]

I have a full thickness tear of my supraspinatus tendon , I am 65 ,will it heal without surgery, mri shows 18 mm tear

[@thomasponnan]

It might heal itself, I think no need for a surgery but your shoulder movements may be limited..

[@Dsuji245]

Hi, how is it going now? I have the same thing as you do. My doctor wants me to do the surgery. I really want to do. Range of motion is very limited now. Sometimes painful.

[@ljpphel826]

I had my shoulder surgery at andrews institute in gulf breeze fl,the doctor did a great job.i only went to therapy 4 times and they were doing to much to soon.bought a rope roller that hangs on door and did my own pt.doctor told me not to go and let the inflammation subside ,and that worked .every day I could lift my arm a little higher.i am lifting weights and working out without any pain.get the surgery, not going to reattach itself,it has to be done.

[@ljpphel826]

Get the surgery, just make sure the doctor does this type of surgery often

[@ljpphel826]

@@thomasponnan full thickness tear is not going to heal itself

[@nancysullivan2772]

Hmmmm. I’m out of hope…it keeps “popping” and feels like my shoulder is pulling my neck!!

[@rickzimmerman9650]

Just had surgery in January for left full thickness tear, bicep tendonesis and labrum debridement. Now, my MRI on my right shoulder shows a partial full thickness tear (14mm) of the supraspinatus tendon. My surgeon suggests PT to strengthen the surrounding muscles and tendons. and then surgery, as it is a full thickness tear and will not repair itself without surgery. So, as far as I know, no biological treatment (PRP or Stem Cell) will bridge that full thickness gap. Any other non surgical treatments or ideas that can help? I am an active 63 year old who has been working out for 40 years.

[@alintampa]

I can't give you an opinion as to what to do but there is a new surgery out involving an inflatable degradable balloon that is inserted into your joint. It's FDA approved. some people are out of the sling in less than 2 weeks and have full recovery after 12 weeks. just something to research and look into in case you decide to go under the knife

[@GoodByeSkyHarborLive]

does it cause pain though if you are active? Why did they debride instead of repair?

[@riddlescom]

Did you get the surgery

[@SuperMortiki]

Question for you if you're still reading your comments. I have had a full thickness Rotator cuff tear for over 3 years now. From what I am reading online recovery even after surgery is questionable being that I've waited so long what is your opinion and furthermore what are my options in your opinion?

[@maggiewagmore8778]

These folks apparently aren't going to respond to your question, so I'll chime in. What you have read online is correct. Any honest ortho surgeon will tell you the same. See my post above.

[@SuperMortiki]

@@maggiewagmore8778 yes, I went to a top notch surgeon (he does surgeries for professional sports) and he stated that my shoulder is too far gone to repair and only a replacement would be justified. 😭

[@maggiewagmore8778]

@@SuperMortiki Sorry to hear that. I'm guessing it's because so much time has passed. Like you, I had a pro sports ortho work on me. Before the MRI, he told me that if there was old damage (partial tears, etc)...it would affect how we would proceed. It's all about the quality of tissue. Fortunately, there was no evidence of previous damage, so we went ahead with surgery. Not long ago, I spoke with someone who had shoulder replacement surgery. While he didn't have the full range of motion of his healthy shoulder, he said the result was better than what he had been dealing with, and was satisfied with the result. Best of luck to you with your shoulder:)

[@HeyIntegrity]

@@maggiewagmore8778 can they determine the quality of tissue before surgery? How can they?

[@maggiewagmore8778]

@@HeyIntegrity MRI and the body of knowledge from decades of study. Muscles and tendons that are damaged/not used will atrophy over time and be less viable. My surgeon told me before the MRI that if the damage was fresh, the prognosis would be much better than if it was old. Fortunately for me, the damage was fresh...there were no old partial tears, so this favored surgical repair. 8 months later... I don't even think about the injury much of the time. Still doing strengthening exercises. Progress isn't as dramatic as it was earlier on, because the shoulder is nearly 100% back to normal, but there is still improvement taking place, it's just in smaller increments. By Thanksgiving it will have been a year, and I expect to be fully recovered.

[@dennismcconville561]

Hey Mike, great video. What about a full tear with retraction. Just got my MRI results back and I have very very little pain a d full function. Can PT help me or is surgery the best idea? TIA

[@Mikereinold]

Depends on the size and tissue quality, but your doc should be able to help you figure that out

[@JPCook-ni9tb]

How did things pan out? Last week I got my MRI showing a full thickness tear. I have decent mobility and almost no pain. Did you get the surgery or no?

[@Mikee535]

@@JPCook-ni9tb Im the same.. full tear full ROM almost no pain. 7 months since ai fell down the stairs. How are you making out?

[@JPCook-ni9tb]

​@Mikee535 Hanging in there. 13 months. No pain. Back to full workouts.

[@richfortin08]

Sorry I’m 31 and this wasn’t an option with brachial plexus and axillary nerve damage as well surgery is definitely needed

[@Mikereinold]

Very true, other factors to consider for sure

[@lashondahursey6116]

@@Mikereinold full distal tear with supra and infra tear 13 by 11mm and bicep tendonosis .mild retraction...any thoughts ? I saw a Ortho he said surgery or try a injection and more pt

[@TheShoulderGuide]

Generally speaking there just is no single right answer. Pros and cons with anything you choose.

[@mz-dz2yn]

Treating Full-Thickness RETRACTED 3CM Rotator Cuff Tears VIDEO

[@alwayshumble8817]

I have full thickness tear and don’t want surgery.

[@evelinayounan8090]

How is your healing.getting better

[@bradlot5104]

​@@evelinayounan8090 he wasn't humble enough to reply

[@sueblattner]

Great topic. Great to hear this information but such a waste if you’re looking to gather facts