My Story of Treating a Torn Rotator Cuff Without Surgery
I tore my rotator cuff (the tendons in the shoulder) several years ago. After my doctor explained my options for recovery, I did my own research to learn everything I needed to know to make the right decision about treatment. Eventually, I decided not to have surgery.
A torn rotator cuff injury can cause pain and limited mobility. The options for having a continued quality of life are either surgery or physical therapy. Here's my experience...
The shoulder is the most complex joint in the human body. It is designed to be able to rotate in all directions. We take this joint for granted and I wish I understood it better previously. With the right knowledge I could have avoided damaging mine.
I’m in my 60s now, but I never think twice about my age. I have always done things as if I were still in my 30s, never giving any thought to the fact that my body is getting older and maybe, just maybe, I should change the way I do things. Taking care of our shoulders as we age can have a great impact on our ability to continue living life to the fullest.
What Can Your Shoulder Aches and Pains Mean?
When I started having aches and pains in my shoulder, I ignored them because I thought that it’s just part of aging. I had pain in my right shoulder when I tried to reach to wash my back when showering. My mother had arthritis, so I thought that might be what was going on for me.
I was still able to lift things, but when I tried to lift heavy boxes over my head I had to quickly shift the weight to my left hand or else drop the box.
My doctor recommended an orthopedist who sent me for an MRI.
The MRI revealed that I had torn three tendons in the rotator cuff of my right shoulder. The rotator cuff is a combination of muscles and tendons that control shoulder movement and maintain the stability of the shoulder.
Since I let a year go by, my orthopedist said that surgery might not be totally successful any more. Besides, I was still able to function. I could lift things, do house chores, and just about anything. However, when I made the wrong move I felt the pain.
My doctor explained that people who are immobilized by a rotator cuff tear are the ones that have no choice but to have surgery. However, in my case, having good mobility and little pain, surgery is the last option to consider.
One of my four tendons had a full-thickness tear. That means that it was completely torn. It retracted like a snapped rubber band.
I found out why waiting a year is not a good idea. With a full-thickness tear the muscle is no longer used and it atrophies over time. This means that it becomes more like fatty tissue. When a surgeon sutures1 a healthy tendon, it holds. When they try to suture through fatty tissue, it just tears right through.
An easy way to understand what I mean is to think about eating a steak. You can't run your fork through the meat, but if you try to pull your fork through the fatty part, it slides right through.
Due to the atrophied muscles, surgery was not a viable option anymore since it most likely would have failed. My orthopedist told me that surgery really needs top be done shortly after the injury if it is going to be a success.
Many rotator cuff tears can be repaired with minimal invasion by a procedure called arthroscopic rotator cuff surgery, if recommended by the doctor and if done in time.
Arthroscopic Rotator Cuff Surgery
Living With a Torn Rotator Cuff Without Surgery
I was curious to know why some friends who had the same problem complained about excruciating pain, or lost their ability to use their shoulder.
My doctor explained that in my case my muscles were well balanced and compensated for the torn tendons. That came from a lifetime of proper exercise. You may laugh at me, but ever since high school I kept doing those push ups that we had to do in gym class. Maybe that made the difference.
Nevertheless, I still hurt myself. How? I don’t know for sure. I have always done extreme things that maybe I should have stopped doing as I got older. I like to do carpentry around the house, and I sometimes move heavy objects, even lifting them above my head to place on racks high up.
That must be it!
I had a discussion with my new orthopedist who I went to for a second opinion. I asked her what I could do to get through the rest of my life if I don’t have surgery. Remember, the surgery might not work that well in my case. In addition to that, it’s not recommended when one still has functionality anyway, as I do.
Her answer was, “Avoid lifting things above your shoulders.”
I asked why. She explained that when we lift things higher than our shoulders we're using our rotator cuff, but we're using different muscles when we lift only as far as our shoulder level.
Wow! That was an enlightening lesson. They should teach us those things in high school to take with us throughout life! (Just like the three R's and the multiplication table.)
Lessons That Should Be Taught in High School
Reading, Writing, 'Rithmetic, and Rotator Cuff
Anyway, I learned that if I avoid lifting heavy objects above my head, I might be okay. Well, my doctor continued to explain that there are no guarantees.
She said it may get worse. Two of my tendons only have partial tears and they are still functional to some degree. However, if I abuse my shoulder it can get worse. The one that has the full thickness tear is already non-functional.
How I Avoided Surgery
Ironically I never needed surgery even though I had a full tear of the Supraspinatus Tendon and a partial tear of two other of the four tendons.
My doctor had sent me for physical therapy. They taught me various exercises to retrain the body to function with the torn tendons, basically by teaching the muscles to handle the stress and keep the shoulder in proper position.
My doctor said I'm one of the few who's at one end of the spectrum—having had a full tear and still able to function 90%. I hardly have any pain and almost full mobility. At this point I wouldn't even know that I had torn three tendons of my rotator cuff except for the MRI that shows the damage.
Don't make any decisions based on what I'm explaining here. I'm just sharing what I had learned. Deciding to have surgery or not is a choice you need to make with your own doctor.
I explained above two reasons why my doctor was against surgery for me:
- I’m functioning and I have full mobility. Mostly due to keeping up with the physical therapy exercises.
- Since I waited a year since the tear, surgery may not be successful since the major torn tendon, the Supraspinatus Tendon, retracted and atrophied.
I'm pretty much okay except that I need to avoid lifting things over my head. That will bring on the pain and can even cause more damage.
Many people have rotator cuff tears without even knowing it. Maybe they are like me, thinking that they are just getting older and expecting discomfort. So therefore they're not getting it checked out.
In a study of cadavers, it was found that 32% of them had partial-thickness tears and a 19% had full-thickness tears.3 Nevertheless, they were functioning the rest of their lives.
Update: Five Years Later
Routine Physical Therapy Keeps My Shoulder Functioning
Over the last five years, I have continued doing the physical therapy (PT) that they taught me. I do it on my own at home three times a week.
I am sure this keeps me going because there were a few times when I stopped for a couple of weeks and the pain came back and I started losing mobility. So each time I went back to doing the PT exercises, the pain once again would clear up.
I never had surgery and I’m functioning very well with full mobility.
I had asked my doctor why it is that I can do almost anything even though the major tendon is completely torn. He said that because I’m doing the PT exercises I am constantly training the other muscles to take over. He added that as long as I continue the PT the rest of my life I might never need surgery, especially since the chance of success are minimal after such as long time.
It will be a lifetime of continuing the PT exercises every other day to keep the other muscles balanced. I can live with that. I'm avoiding the pain and I'm keeping full mobility.