The Grumpy Old Shoulder. Age-Related Rotator Cuff Tears and Physiotherapy

Rotator cuff tears are extremely common in society, with up to 65% of these existing without symptoms. Often it can be quite a shock to learn you have a tear without ever having a traumatic event.

Once you reach your 40s, there is a 6.7% chance you have a rotator cuff tear without even knowing it! This increases to 13% in your 50s and 25% in your 60s! Despite these tears your shoulder often remains functional and the tear will cause no disability.

However, it is thought that these degenerative tendons can become painful when excessive load and strain are repeatedly added through overuse and abnormal scapula (shoulder blade) mechanics.

As the tendon tries and fails to heal, it begins to grow blood-vessels and nerve endings within the tendon, increasing pain sensitivity and often causing night pain.

Early physio management of these tears can lead to excellent results. With poorer outcomes seen in people with tears more than 1cm in size, having increased functional impairment or with over a year of shoulder pain.

Often these shoulders will have a poor scapular position causing compression of the tendon, this needs to be rectified with your physio through motor control and strengthening exercises.

The longer you let it go the harder it is to fix!

The physio also needs to work with you to create a carefully graded loading program that helps the tendon adapt and regenerate, but not so intense that it causes excessive tendon thickening and pain.

Unfortunately, these injuries respond slowly to treatment, and can take 12-18 months to be back to 100%. However, a significant improvement in symptoms can be expected with just 6-12 weeks of management!

The shoulder is a complex joint and hence there is no one size fits all approach. Book today with SmartMoves so one of our team can tailor an exercise program just for you.

Source: Bleichert, S., Renaud, G., MacDermid, J., Watson, L., Faber, K., Lenssen, R., Saulnier, M., Phillips, P., Evans, T. and Sadi, J., 2017. Rehabilitation of symptomatic atraumatic degenerative rotator cuff tears: A clinical commentary on assessment and management. Journal of Hand Therapy, 30(2), pp.125-135.