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The rotator cuff comprises of four muscles, originating from the shoulder blade and inserting onto the outer part of the shoulder. Not only do these muscles work to move the arm, they also act as stabilisers of the shoulder joint.
Injury to these muscles or tendons are common, and can range from tendinopathy to partial tears, and ultimately full thickness tears. Age appears to play a significant part to injury, where 9.7% are 20 years and under, to 62% in those over 80 years of age. Interestingly, there is a 50% likelihood of patients over 66 years suffering tears in both shoulders.
Research looked into what treatment (conservative or surgical) offers the most favourable outcomes. Results indicated that treatment depends on age, their functional demands, and acuteness vs. chronicity of the tear. Firstly, non-surgical management is almost always advised providing they are responding with improved function and decreased pain. For those that fail to respond to conservative treatment, then surgical repair is advised. For chronic, large tears then a partial and/or reconstruction would be indicated.
For patients who do respond to conservative treatment, will do so in 6-12 weeks. A recent meta-analysis published in 2019 in the United Kingdom revealed both surgical and non-surgical treatment groups had the largest improvement at 12 months, and there was no clear advantage between the two interventions. Knowing this, patients should be guided appropriately by their health care professional.