23/12/2025
https://www.facebook.com/share/p/1DsyFnmWqV/
๐กโ๐๐ ๐ฎ ๐ฟ๐ผ๐๐ฎ๐๐ผ๐ฟ ๐ฐ๐๐ณ๐ณ ๐๐ฒ๐ฎ๐ฟ ๐ก๐๐๐๐ฆ๐ฆ๐๐ฅ๐๐๐ฌ ๐๐ต๐ฒ ๐ฐ๐ฎ๐๐๐ฒ ๐ผ๐ณ ๐๐ต๐ผ๐๐น๐ฑ๐ฒ๐ฟ ๐ฝ๐ฎ๐ถ๐ป?
Letโs examine the clinical evidence:
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Rotator cuff tendon degeneration and tearing are highly prevalent, especially with advancing age, and are often considered part of the normal aging process. The majority of these cases do not require surgical repair.
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Rotator cuff tears are not always symptomatic โ the presence of a tear does not guarantee that it is the source of the patientโs pain.
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Structured physiotherapy programs of at least 12 weeks duration can yield outcomes comparable to surgical intervention. Importantly, post-operative protocols still involve a period of immobilization (typically 4โ6 weeks) followed by a rehabilitation program that closely mirrors non-operative care.
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Re-tear rates are higher following arthroscopic repair compared to open repair (46% vs. 39%).
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Post-operative re-tears do not necessarily correlate with poorer clinical outcomes, suggesting that anatomical healing is not the sole determinant of functional recovery.
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Surgery may be indicated in specific casesโsuch as acute, traumatic tears in younger or high-demand individualsโbut most degenerative, non-traumatic tears with minimal functional impact do not require surgical intervention.
And importantlyโฆ
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Elite overhead athletes, such as baseball pitchers, are capable of performing at high levels (in terms of velocity, accuracy, and power) despite having full-thickness rotator cuff tears, often without any pain or functional limitation. Long-term follow-up (up to 5 years) shows sustained pain-free function in many of these cases.
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This raises an important clinical question: If high-performance athletes can function without pain despite full-thickness tears, why shouldnโt our patients be able to return to meaningful activities without surgery?
References: Lewis (2016), Lewis (2018), Carr et al. (2017), Brindisino F et al (2025)
