There are times when shoulder surgery is the best option.  

Rotator cuff tears resulting from a hard fall or accident are often good candidates for surgery.  If the accident was bad enough to have potentially dislocated or fracture the shoulder, we advise an urgent trip to have it evaluated by a sports medicine professional.

But for many rotator cuff tears, surgery is not the best option.

Most shoulder problems can be fixed with a smart rehab program—avoiding the pain, downtime, and cost of surgery.   

Consider the following before going under the knife for a rotator cuff repair.

1. Can Your Life Handle the Ordeal of Surgery?

Rotator cuff surgery is not like replacing the worn-out tires on your car—an hour at the tire center and you are back on your way, good as new.

Shoulder surgery includes a life-altering recovery process.  Will the current demands on your life allow for weeks of needing assistance with basic tasks like tying your shoes and washing your hair? And the number one complaint following surgery is painful sleepless nights.

Expect discomfort with no shoulder activity for up to eight weeks, then lifting no more than 5 pounds for another 20 weeks.  If that doesn’t excite you, then…

Shoulder surgery should be the last option to fix a rotator cuff tear.

Especially when other treatment options are as effective as surgery.

Yes…you read that right!  

Many medical studies show that an exercise program is just as successful as shoulder surgery without all the complications.

Success is defined as the patient’s ability to perform the same activities they were doing before the injury and maintaining these long-term results for years.

2. Can You Afford the Cost of Surgery?

Shoulder surgery often exceeds the costs of nonoperative treatment by about $13,000 (ref).

Even with insurance, deductible and co-pays add up, along with the cost of taking time off work.

The significant extra cost and hassle of surgery should come with better outcomes – but it doesn’t.

A recent study showed 3 out of 4 people with rotator cuff tears were able to avoid surgery and return to their normal lives by using a rehab program to treat their shoulders (ref).

Although you might be worried that passing on surgery will return to haunt you down the road?

A study in the Journal of Shoulder and Elbow Surgery, followed patients who passed on surgery for 13 years. They found 9 out of 10 had little to no pain in their shoulder without surgery (ref).

3. Are You OK With the Risks?

In addition to the commonly known risks of surgery (infection, pain, failed procedures, etc.), it’s important to consider the longer-term risks to performance.

First, look at elite overhead athletes because they are special cases. Many assume the highest-level athletes—with unlimited money and resources— will get surgery because they can afford the best care.

However, this is not always true because surgery could threaten their performance.

Changes in anatomy and movement of the shoulder following surgery can forever impact how the shoulder moves.  Shoulder range of motion, mechanics, and strength are affected for a long time and sometimes forever, which any athlete wants to avoid (ref).

For example, it’s reported that only half of the Major League Baseball players who undergo shoulder surgery will have a successful return (ref).  With those numbers, it’s important to have exhausted all other options first.

But this applies to the other 99% of athletes who do not receive a paycheck or scholarship for sports performance.  Because what’s the risk of conservative management?

Nothing!

That’s right!  Relatively no risks exist for conservative management of a degenerative rotator cuff tear. Those tears often take years of faulty mechanics and other factors to develop. If done properly, a 6-week trial of conservative management will not make things worse.

Worst-case scenario, if a few weeks of rehab don’t improve things, your shoulder will be in better shape for surgery.

For that reason, trying an exercise plan before deciding on surgery is absolutely worth it!

Boiling it Down

Ultimately, every condition is unique and deserves individualized decision-making. But too many people believe that shoulder surgery is their only option for returning to their life pain free.

Hopefully, this article has made you aware of the success of a shoulder pain rehab program, even for conditions as severe as a rotator cuff tear.  We want you to be more active in the discussion regarding the next steps for YOUR treatment plan!