Question:I've heard it's possible to rehab a torn rotator cuff without surgery. How is that possible?
Answer:The rotator cuff is a group of four muscles and tendons that converge on the shoulder. Together they form a sheath or envelope that wraps around the shoulder. The fibers interlock and crossover forming layers that are all connected together.
This protective overlap makes it possible for one muscle to take over and help function for another. This concept is called redundancy in function. Rehab can focus on strengthening the muscles that aren't torn and restoring the torn tendons as much as possible.
A physical therapist can perform a special massage called transverse friction massage to help align the healing fibers. Instead of adhesions and scarring going in all directions, the fibers line up in parallel. This helps keep the shoulder supple and moving smoothly.
Not all tears do heal without surgery. Various factors such as patient age, condition of the tissue, and depth of the tear determine the final outcome. Results also depend on whether more than one tendon is involved and the location of the tears.Peter J. Millett, MD, MSc, et al. Rehabilitation of the Rotator Cuff: An Evaluation-Based Approach. In Journal of the American Academy of Orthopaedic Surgeons. October 2006. Vol. 14. No. 11. Pp. 599-609.
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