severely torn shoulder muscles, should I get surgery/only physical therapy?

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my father has severely torn muscles on both shoulders, and it's quite painful, we are considering whether we should get him a surgery to tack the muscles back, but on second thoughts we feel surgeries might be too invasive, we have all heard about stories of how doctors cut off too much muscles or ligaments or other important organs during surgery which result in permanent loss of certain functionings/inability to return to baseline. my father has talked to 4 different doctors, 1 recommended surgery while the other 3 doctors says he will recover with just physical therapy. 

one thing I want to note is the 3 doctors who claimed my father's muscle injuries would recover with just physical therapy, when they checked out my father's injuries they all asked my father to perform the same test, which is to do a full 360 degree rotation of my father's upper arms around his shoulders. and my father, as of recently, is able to perform this task. that's why the 3 doctors recommended physical therapy.

my father first got his should muscles severely torn back in March 2018, at that time he did a MRI, below are the findings of his MRIsadplease note these findings are dated back in March, when he first got his muscles torn. but since then it's been 5 months and many parts of his torn muscles have grown back and healed. I asked my father to get a new MRI again but he says it's too expensive. but I just want to note that it's best not to base the recommendation solely based on these outdated MRI finding. as I mentioned before, my father as of recently is able to perform the task of 360 degree rotation of his upper arms around his shoulders, something he couldn't do when he first got his muscles torn back in March. )

FINDINGS: There is enlargement of the AC joint. there is irregularity of the inferior aspect of the acromion. there are high-grade partial tears with severe tendinosis of the tendons of supraspinatus and infraspinatus.leakage of fluid into the subacromial and subdeltoid space is clearly demonstrated without retraction of the partially torn tendons of supraspinatus and infraspinatus. the subscapularis and teres minor are intact.the glenoid is intact. the labrum of the glenoid is well preserved. significant irregularity with subchondral cystic formation of the greater tuberosity of the humeral head is identified. the coracoacromial ligament is mildly thickened.

Impression: High-grade partial tears of the tendons of the supraspinatus and supraspinatus with leakage of fluid in the subacromial and subdeltoid space of the left shoulder. excessive osteophyte formation of the greater tuberosity of the humeral head and irregularity of the inferior aspect of the acromion are most likely the causes of rotator injury. chronic recurrent injuries by chronic impingement should be considered. no retraction of the injured tendons of supraspinatus and infraspinatus demonstrated, however. 

should we get surgery or only physical therapy. I hear even with surgery the muscle can't regrow back to more than 60%-70% its baseline functioning. thank you for your recommendation, we really appreciate it!

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  • Posted

    I had a torn rotator cuff about 9 years ago and PT made it worse. I finally had to have surgery to repair the tear and I have not had any further pain or problems with it since. Everything healed well and I have full range of motion and strength in the shoulder/arm. I now have severe pain in my other shoulder that came about over the last few months to the point that I think it is torn as well. I had an xray done yesterday to rule out any skeletal injuries. If nothing shows I will have to get an MRI. My advice is if you try the PT and the pain gets worse, then STOP it immediately. Sometimes cortisone injections help with the inflammation and pain if the surgery is not an option. 

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