Physical therapy is often recommended as an initial treatment for a rotator cuff tear. However, physical therapy doesn't help the torn rotator cuff tendon heal.
Why is this often used as the first treatment?
Treatment of a Rotator Cuff Tear
The goal of treating a rotator cuff tear is not necessarily to heal the torn tendon. People can often achieve pain relief and improved strength by relieving inflammation and restoring shoulder joint mechanics. This can be accomplished with physical therapy and anti-inflammatory treatments, including medications, cortisone injections, and ice application.
How does physical therapy help rotator cuff tears?
The goal of physical therapy is to improve the function of the muscles that surround the shoulder. Most people, athletes and weight-lifters included, only strengthen a few of the large muscles around the shoulder. Physical therapy targets the smaller, but important muscles around the shoulder that are commonly neglected. By strengthening these muscles, therapy can help compensate for damaged tendons and improve the mechanics of the shoulder joint.
It can be difficult to grasp the concept that the rotator cuff tear does not necessarily need to close for pain to be resolved. However, the truth is that the vast majority of patients who have a rotator cuff tear will not need surgical treatment. Determining when surgery is necessary for a rotator cuff tear depends on a number of factors you can discuss with your doctor.
Sources:
Iannotti, JP "Full-Thickness Rotator Cuff Tears" J Am. Acad. Ortho. Surg., Mar 1994; 2: 87 - 95.


