Rotator cuff injury, disatisfied with Dr's reaction.

Hi, I am in Canada too. I've read a lot over the last year due to my own three surgeries and complications, and I believe partial tears are usually treated conservatively first. Have you done 3 months of solid physio to build up the rotator cuff strength? I recommend getting a very good manual PT and go twice a week for three months. If you aren't happy after that take another step. Surgery is very debilitating... it is 16 solid weeks of pain and sleepless nights each time for me!

I think it would be worth getting a second opinion. If you have already endured a decade with this, it's not urgent. Don't know your age or occupation, but if you are going to have surgery you shoule be certain that is the right path. Although certainty  is hard to come by 100% under any circumstances. I had a cortisone injection 10 weeks after my injury and my range improved and pain decreased by there was still weakness and obvios muscle wasting. But some people get considerable improvement with the cortion and physical therapy. I would have loved to avoid surgery. It's not been a picnic and I still don't know the end result. Even with full thickness tear of 2 tendons over 3 cm and 3 cm retracted I still hesitated and dragged my feet. But the Dr was pretty clear that surgery was my best option and an "investment in my future." It's a very personal decision. Ask questions...try therapy...all the conservative measures available, get second opinion. Wish you the best.

I have had tears on both my shoulders, one was clearly diagnosed as needing surgery the other more conservative treatment, cortisone and physio. I was dubious to the effectiveness of this but given I was already recovering from one surgery agreed and committed to programme. I found there was little improvement early on but perservered with physio and I have seen steady improvement to the point where I feel more confident that I might avoid surgery.

My physio told me that 80% of RC tears can be treated this way successfully, don't know how true this is but he is a good guy!

I need to do excercise everyday to improve and maintain my arm but following the initial exstreme pain, I am now virtually pain free, unless I do something stupid. I am hoping for a good recovery.

Hope this was helpful as it is simply my experience.

Thanks for the replies, very helpful. Hearing that surgery was the only option for larger tears (and full thickness) is reassuring. From what I can discern, subscap & supraspinatus are roughly 12mm thick, so I'm sitting at 1/3 thickness, approximately. It hurts like the dickens, but it looks like I'm half way gone (or half way good?), so perhaps I'll look more seriously at physio. I know surgery is rough, especially so in the shoulder (my ACL reconstruction was a dream compared to some of the stories I've read for shoulders), so I'd like to avoid it if possible, but sometimes, oh boy!

LessrTuberosity, what do you consider "manual" PT? I did see a sports therapy guy for a bit, it seemed a lot like range of motion and some serious thumb-work on the scar tissue, usually for about 30-45 minutes per visit weekly. Once I felt better I stopped (of course). Is that the kind of PT you're talking about? I wasn't ever sent home with "homework" between visits (I was given "homework" during my ACL recovery).

Thanks again for the responses!

B.

Just an FYI on "manual therapy" which can encompass many different techniques and styles. Generally, friction massage for 30-40 min over a scar sounds excessive. There is mobilization, which is usually gentle manual manipulation of the joing in order to lossen a tight joint capsule...which may be cause of pain and restricted range of motion. There is manual stretching (long, slow, static is best) of the tendons and muscles around the joint also to improve range and decrease pain. there is myofascial release (which is a type of manual therapy) good to release restrictions, including scar tissue and rebalance structure thus improving range and regaining strength...and there is good old fashion massage....which could be deep tissue or more superficial. strengthening should follow stretching and should begin light another poster pointed out you are working at strengthening muscles that are small initially and don't want to recruit the larger muscles that can substitute and takeover for the smaller rotation muscles. I hope you are able to avoid the surgery.

Sorry to read your story.  Frustrating for sure.  There is a lot of information on the internet.  One that I have found helpful is titled Arthroscopic Rotator Cuff Repair Frequently Asked Questions.  The article is current (2016) through Brigham and Womens' Hospital in Boston, Massachusetts.  The article is 34 pages in length.  User-friendly written, extremely informative with photographs.  I am in the ninth week out of my surgery and wish I had read the article three months ago.  I would have done a few things differently based on the information.  Good luck and keep us posted.