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Thursday, October 11

Do I Need Surgery for my Torn Rotator Cuff?

Let's start with this: you have shoulder pain, and have seen a doctor about it. The doctor orders an MRI, and it shows a tear in the rotator cuff. You might then ask: will the tear heal on its own? do I need surgery?

First things first: Will a torn rotator cuff tendon heal on its own? We actually know the answer to this, and the answer is no. Tears in the rotator cuff do not heal with time. Studies show that even years after a tear is discovered, repeat MRI scans show there is no evidence of healing.

So we know the torn tendon doesn't heal.  Does this mean that I have to have surgery!?   If you want the tendon to heal, then the answer to this question is yes.  But consider this: many people live their entire lives with a tear in the rotator cuff, with no problems, and no or minimal pain.  So it is possible to live with a tear and do just fine.

In my practice, I generally recommend surgery for patients younger than 50 years old.  Between 50 and 65, it really depends on the patient: active people who need their shoulder for work or recreational activities should strongly consider surgery.   For patients over 65, I recommend surgery as a last resort, only if therapy and injections aren't helpful.

In summary, torn rotator cuff tendons do not heal and I recommend surgery for most patients younger than 65, especially those younger than 50.  Some patients older than 65 do well without surgery.

For more information about rotator cuff repair, see my previous blog posts.