Glenn Stok is a technical writer who researches health-related issues and shares his knowledge to inform those with corresponding questions.
I had a complete tear of the Supraspinatus Tendon of the rotator cuff and I discovered that treatment does not always require surgery.
After my doctor explained my options for recovery, I researched everything I needed to know to make the right decision, and I discovered treatment does not always require 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.
I'll tell you about my experience.
What Is the Rotator Cuff?
First, let me give you a brief explanation. The rotator cuff is a combination of muscles and tendons that control movement and maintain the shoulder's stability.
We have four tendons in the shoulder, which 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 that better previously. With the right knowledge, I could have avoided damage.
How I Tore My Rotator Cuff
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 that maybe I should change the way I do things.
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 since I was getting older.
I was still able to lift things, but when I tried to lift heavy boxes over my head, I had to shift the weight to my left hand quickly 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. Two were only partial tears, but I had a full-thickness tear of the Supraspinatus Tendon.
Waiting Too Long After a Rotator Cuff Injury
Since I let a year go by, my orthopedist said that surgery might not be successful anymore. 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.
I found out why waiting a year was not a good idea. With a full-thickness tear, the muscle is no longer used, and it atrophies over time. That means 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 should to 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.
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 my muscles were well balanced and compensated for the torn tendons in my case. That came from a lifetime of proper exercise. You may laugh, but since high school, I kept doing those push-ups 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!
Remember, the surgery might not work that well in my case, after waiting so long. In addition to that, it’s not recommended when one still has functionality anyway, as I do.
I discussed this 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. Her answer was, “Avoid lifting things above your shoulders.”
I asked why. She explained that we use different muscles when we lift things only up to shoulder level, but when we lift things higher than our shoulders, we're putting the stress on our rotator cuff.
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.)
Taking care of our shoulders as we age can have a great impact on our ability to continue living life to the fullest.
I learned that if I avoid lifting heavy objects above my head, I might be okay.
My doctor continued to explain that there are no guarantees. She said it might 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.
Why Second Opinions are So Important
The first orthopedist I saw told me I needed surgery, or else it will continue to get worse. I felt like she was focusing on doing as many surgeries as possible in her practice.
Another doctor was honest enough to say that surgery might not help any better than routine physical therapy. As it turned out, that was all I needed.
Now, years later, I'm pain-free with full mobility. The trick was that I needed to continue the PT exercises two or three times a week at home. Diligence with continued exercise is what's necessary.
That might not be the solution for everyone. It all depends on your physical makeup and health. You need to discuss the alternatives with your doctor and try to be sure they are not just looking to do surgery for the money.
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 training the working muscles to keep the shoulder in the 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 if it weren't 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 doctor.
I explained above, the 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 19% had full-thickness tears.3 Nevertheless, they were functioning for the rest of their lives.
Constant Physical Therapy Keeps Me Functioning After Nine Years
Over the last nine years, I have continued doing 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 a few times when I stopped for a couple of weeks, the pain came back, and I started losing mobility. 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 I am continually training the other muscles to take over because I'm doing the PT exercises.
He added that as long as I continue the PT for the rest of my life, I might never make it any worse.
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 maintaining full mobility.
Resources and References
1. Suture - Merriam-Webster Dictionary
2. Rotator Cuff Injury - Mayo Clinic
3. Keun Man Shin. (June 3, 2011). “Partial-Thickness Rotator Cuff Tears” - U.S. National Library of Medicine
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
Questions & Answers
Question: I had Orthoscopic surgery on my right shoulder. The doctor said it was going to be easy for me, but I’ve had a lot of pain. Now, six days later, I’m still tired and uncomfortable. How long this will last?
Answer: Recovery after surgery varies for each individual. Your success is partly dependent on how well you do with your physical therapy. PT should have been assigned for the weeks after surgery.
Talk to your therapist about your questions. Having your records, and knowing your situation, he or she will be able to give you a more definite answer and also help you with your concerns.
© 2012 Glenn Stok
Glenn Stok (author) from Long Island, NY on October 16, 2017:
Mickey West - I’m surprised your doctor didn’t send you for an MRI. That’s the only thing that will show if you tore a tendon. And yes, it will show up a year later if it’s still torn.
Your doctor should also have sent you for physical therapy. The PT may help alleviate the pain. It did for me, and without surgery.
And I still do the PT exercises at home to keep my range of motion without having pain.
If you did indeed tear your roator cuff, surgery a year later may be too late for a successful outcome since the muscle atrophies, as I mentioned in this article.
PT is important and is the only thing that may help you at this point. Go to your doctor and insist on it.
mickey west on October 16, 2017:
I fell 10 months ago on the ice. Tripped on my ice cleat and fell forward onto my right shoulder/upper arm. I was walking the dog & had his leash tied to my right wrist & she kept running & I slid across the ice a few feet before she stopped. By that night I could barely move my arm. I went to the dr's 2 days later & they did regular X-rays to make sure I didn't break anything which I hadn't. That was it. I went back in March for my regular check up and had kept my shoulder/arm moving through the pain so I had full ROM but pain on certain movements and horrible overnight pounding pain. My doctor gave me a cortizone shot in the upper arm because he felt like I had hurt the tendon. The shot worked pretty good for about 4 weeks then the pain came back. It's now 10 months since I first fell and I'm still having horrible night time pounding pain and some daytime pain with certain movements but bearable during the day. I wish I had gone back to the doctors and wonder if almost a year later if I had an MRI would anything even show up all this time later? I am a 63 year old woman and don't want surgery but want some relief from the pain during the night. Not sure what to do.
Glenn Stok (author) from Long Island, NY on October 09, 2017:
Barrie - An ultrasound is not going to give enough information to decide if you need surgery. You need an MRI in order for your doctor to determine the exact extent of your injury. That’s why you got different results when you went for the MRI. Unfortunately, worse results.
You seem to be in the same boat as I am, and for the same reason. I also did exercise all my life, so my doctor said my other muscles are compensating for the one lost due to the full tear of the supraspinatus tendon.
Be careful with the weight training. You need to change your lifestyle now. You only have three tendons remaining. If you tear another you will be in big trouble. I found, after seven years so far, that I am doing fine without surgery.
The only thing is that I need to continue the physical therapy that they taught me. When I stop for a week or so, I feel the pain again and begin to lose mobility. So I go back to the PT exercises, and I’m back to normal⎯as normal is for me now.
I have accepted the fact that I can’t (and should not) lift heavy weights above my head. That would create a disaster with my shoulder. This applies to you too.
As far as considering surgery, that’s something you have to decide with your doctor. Make sure you tell him or her all the facts about your lifestyle. I’m referring to your desire for weight training. I hope you’re not taking about heavy weights. You need to accept the fact that you have a full tear. A full tear means that one muscle is no longer working for you.
Take care of yourself, and best of luck to you.
Barrie on October 09, 2017:
I have been diagnosed with a full tear to my supraspinatus tendon but am considering whether to have surgery to repair it. I had some pain and some limited movement and was diagnosed with a partial tear after an ultrasound.
However, by the time I had my MRI, the pain wasn't as bad and the movement is still limited, but not so painful - the MRI showed a full tear. I believe the pain was occurring when it was partially torn and now that it has torn completely, the pain isn't as bad.
I have been weight training for over 20 years so have strong shoulders which my surgeon thinks is compensating for the tear and this is why I am still able to continue with training, albeit adapting one or two exercises which are uncomfortable.
In my last appointment with my surgeon, I explained I am concerned about the recovery time after the op as I would not be able to weight train and I see the gym as a very important mental release after a stressful day at work. My surgeon then said he is now wondering how much more he can give me if he operates and he wants to think about it for another month or so.
Having read your story, I am seriously considering saying no to any surgery - would you agree?
Glenn Stok (author) from Long Island, NY on August 20, 2017:
Janine Mills - You tore the same tendon as I did, the Supraspinatus. It's interesting that the acupuncture worked with that, but I assume the major advantage was from the PT you were also doing with resistance training. I so far have continued to avoid surgery simply by constantly retraining the muscles to take over for the one that's useless due to the complete Supraspinatus tear.
Janine Mills on August 20, 2017:
Hi folks. Thanks Glen for your story, it has helped convince me that I also made the correct 'non surgery' choice and by continuing with strength training exercises that my PT showed me, plus a few more, I have such a greater range of movement that I almost feel brand new. Well maybe not quite, but it's going to take time I believe. There is so much information available on the internet about this issue which basically answered all my own inquisitive questions. I had carried this lifeless limb around for many months at the beginning of this year before throwing in the towel and seeing a GP as I too do many silly things to myself and being 60, I thought it was a simple strained muscle, but when it did not improve with rest, I figured I might need a second opinion from a professional. She sent for some scans and then referred me to a PT. I was offered acupuncture to help with that dull ache down my arm. I was very sceptical to this but willing to try and it worked immediately. A few sessions later and armed with strength training exercises I too found great improvement with my torn Supraspinatus tendon. It is quite manageable as long as I keep up those resistance band stretches and I sure know it if I do the wrong thing. I'm happy with how it's all turned out and I like to let others know that if they're like me and like to know the ins and outs of everything, then research,research, research first. Then make that decision.
Glenn Stok (author) from Long Island, NY on July 20, 2017:
Sunshine Rivera - Your story sounds very much like what I went through. I also had a full tear of the supraspinatus tendon. I had the impression that the first doctor I saw just wanted the business since he tried to talk me into having the surgery. Lucky for me, I found another doctor who was honest enough to say that surgery in my case might not be of any help. As it turned out, the physical therapy was all I needed, and, like you, I'm functioning very well now with full mobility and no pain. It's good you gave yourself time to think about it first.
Sunshine Rivera on July 20, 2017:
Thank you so much for your article. It seemed like my ortho dr was pushing me too quick. Had an MRI and in 10 min he explained what happened, the results, the surgery, the things that can go wrong, the terrible things that were going to happen if I DIDN'T have the surgery, the recooperation and then pretty much just told me to go see his girl to schedule the surgery! He had me believing that I would just have a limp limb hanging by my side if I didn't have the surgery. My head was spinning and I had questions but couldn't sort them all out in that short time. When I went to the desk his girl was ready to schedule the surgery and I was able to pull myself together enough to tell her - No I need to think about this first. Since I walked out of his office I have had this feeling as though I should not go through the surgery. Its been 8 months since I tore the supraspinatus and I am functioning well. I didn't want to be pressured and I couldn't find anything on the net about if I didn't have the surgery until I read you article. It has helped some. Thank you very much. I'm sending this to my hubby to read, as well.
Glenn Stok (author) from Long Island, NY on May 27, 2017:
Heidi - Sorry to hear what you went through, but thanks for adding that information to the discussion. Your experience goes to show how proper exercise and physical therapy can improve functionality without surgery. Like you mentioned, I also have to continue weekly exercises to maintain almost 100% mobility. It's amazing how the human body can compensate for damage when one is willing to do a little work.
Heidi Thorne from Chicago Area on May 27, 2017:
Had an accident where I tore my rotator cuff by 50%. I didn't do surgery either. It was a long road back with exercises. Range isn't 100%, but darn close. Still need to do exercises to maintain range and flexibility. But I'll choose that over surgery any day. Thanks for sharing your experience!
Glenn Stok (author) from Long Island, NY on October 25, 2013:
PegCole17 - I'm glad to hear that you never needed surgery for your torn rotator cuff. It's been almost three years now since I tore mine and I'm doing fine even without surgery. Just as you said, the physical therapy was all that was needed. And I continue till this day doing shoulder exercises, which keeps me from needing surgery. Thanks for your positive comments about my article.
Peg Cole from Northeast of Dallas, Texas on October 25, 2013:
This was really educational and provided answers to many of my questions. Recently I found out I had torn my rotator cuff, but thankfully, it does not require surgery, just physical therapy. Thanks for the great explanation and information.
Glenn Stok (author) from Long Island, NY on April 16, 2013:
Marie Flint - It's interesting that I am running into more and more people who have had rotator cuff surgeries lately. I hope your brother and son-in-law have had success with it. Be careful about lifting heavy things over your head. I learned now the hard way that it's something we should avoid doing after a certain age. Thanks for your feedback on the graphics I have used. But I would also be interested to know what needs to be polished. I'm always open to make improvements.
Marie Flint from Jacksonville, FL USA on April 16, 2013:
Both my brother (age 58) and son-in-law (31) have had rotator cuff surgeries. I'm glad you had a doctor who didn't push surgery. Personally, I try to do a few pushups regularly. And, I can't recall lifting anything heavy over my head--maybe I never will.
Thank you for sharing your experience. I especially like your pictures. And, while the article can be polished a little more, I think you have done a really nice job (especially those graphics)!
I'm bookmarking this one.
Jason Menayan from San Francisco on January 31, 2012:
Very useful advice - I had no idea that this problem was so prevalent, but your point that most people who just blame it on getting older seems to indicate why. Kudos to you for keeping up with pushups, and as for your current treatment protocol, there isn't a whole lot above your shoulders you'll want to grab/lift anyway. ;)