The physical therapy program in this study was highly effective in alleviating patient symptoms despite the fact that patients continued to have tears in the rotator cuff. This leads one to believe that pain may not be the best indication for rotator cuff repair. Weakness or loss of function may be a better indication for surgery than pain. Further analysis of this cohort will be undertaken to identify those features that distinguish patients who decided to have surgery from those who did not. These data should provide some insight into the features that predict failure of nonoperative treatment and should help clarify indications for surgery.
This large, multicenter prospective cohort study has shown that a specific physical therapy protocol can be very effective in treating symptoms in patients with atraumatic full-thickness rotator cuff tears. If failure is defined as patients electing to have surgery, then this program is successful in approximately 75% of patients at 2-year follow-up. Interestingly, much of the physical therapy was done at home, with patients averaging slightly more than 1 physical therapy visit per week. Physical therapy is not ideal for all patients, and some will elect to undergo surgery early. Others may be at risk for symptom or rotator cuff tear progression. Decisions regarding surgery should be made individually with each patient but should include information that the physical therapy program used in this study is highly effective in alleviating symptoms.
This information is from a multi center prospective cohort study on “effectiveness of physical therapy in treating atraumatic full thickness rotator cuff tears”. It was published in J. Shoulder and Elbow Surgery (2013) 22, 1371-1379. Click HERE for the full study.