Shoulder Tendon Tear: Treatment
The rotator cuff is a group of four muscles and tendons (supraspinatus, infraspinatus, subscapularis, teres minor) that contribute to the stability and smooth movement of the shoulder. A shoulder tendon tear can be caused either by an acute injury or by multiple minor injuries over the years. Most rotator cuff tears are progressive, beginning as tendinitis or inflammation of the tendon that eventually leads to a tear. The tendon most commonly affected is the supraspinatus tendon. The tear may be full-thickness (complete) or partial-thickness.
How is a shoulder tendon tear diagnosed?
The first stage of diagnosis is the clinical examination. The orthopaedic surgeon will ask you to perform a series of movements in order to assess the extent and severity of the injury. Mr. Leonidou will perform an ultrasound examination to assess the integrity of the tendon and the possible presence of fluid and/or calcifications. In addition, an X-ray is required in order to rule out other conditions. In some cases, an MRI scan is necessary.
Based on the above information, the specialist shoulder orthopaedic surgeon will determine the most appropriate treatment for you.
Treatment options for a Shoulder Tendon Tear
Treatment depends on the type and extent of the tear, as well as on the patient’s activities (work and sports). Traumatic rotator cuff tears usually require surgical repair in order to suture the tendon. However, in several cases, conservative treatment is recommended.
Conservative treatment is initially recommended when:
- the tear is partial-thickness
- the tear is chronic – degenerative
Surgical treatment is recommended when:
- conservative treatment fails
- there is an acute injury
- the extent of the tear is large
- the patient performs manual work
- the patient’s level of athletic activity is high
Conservative treatment of a shoulder tendon tear
Conservative treatment of a shoulder tendon tear includes:
- Rest
- Activity modification
- Ice therapy
- Non-steroidal anti-inflammatory medication
- Physiotherapy
- Shoulder strengthening with exercises aimed at reducing pain and restoring range of motion
- Biological therapies, using autologous healing factors from platelets (PRP)
Surgical treatment of a shoulder tendon tear
Surgery for the treatment of a shoulder tendon tear is performed with shoulder arthroscopy. This minimally invasive technique is performed through small incisions, using a specialised camera and specialised instruments, and allows the orthopaedic surgeon to identify the site of the tear and repair the damage. Hospitalisation is not required, and the patient is discharged from the hospital a few hours after surgery. Recovery time depends on the size and severity of the tear that was repaired. Postoperatively, a personalised rehabilitation protocol is followed under the guidance of our team’s physiotherapist.
Frequently asked questions
What are the symptoms of a shoulder tendon tear?
The most common symptoms are pain at rest and at night, especially when lying on the affected shoulder, pain when lifting or lowering the arm, and weakness when lifting or rotating it. Tears caused by a fall usually cause intense pain and immediate weakness, while some wear-related tears are not painful but may still cause weakness.
Can a shoulder tendon tear get worse?
Yes. A tear can get larger over time, especially if you keep using the shoulder despite increasing pain. That is why persistent pain needs assessment: early treatment helps prevent symptoms from getting worse, and in about 80 to 85% of patients non-surgical treatment relieves pain and improves shoulder function.
How is a partial tear of the shoulder tendon treated?
In a partial tear the tendon is still attached to the bone but is thinner than normal, and treatment usually starts without surgery: rest, activity modification, ice, anti-inflammatory medication and physiotherapy with strengthening exercises. Surgery is considered if non-surgical treatment does not help.
If shoulder pain is disrupting your sleep or daily activities, visit shoulder orthopaedic surgeon Andreas Leonidou. The doctor has 14 years of continuous experience abroad, including as a Director at a University Hospital, and specialises in shoulder arthroscopy.
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