Understanding and interpreting your shoulder scan results
“I went to my GP with a sore shoulder and they sent me for scans and it came back with a rotator cuff tear. What does this mean and what do I do?”.
This is something we commonly hear in the clinic and we understand scan findings can be difficult to interpret.
Firstly, let’s look at what a rotator cuff tear actually is. The rotator cuff is a series of muscles that help to stabilise and control your shoulder and arm movements. Rotator cuff tears are generally divided into full or partial thickness depending on the amount of fibre separation seen on the scan. However, this does not have any significant bearing on the pain you may be experiencing. A study by Dunn et al. (2014) looked at 393 people with rotator cuff tears and found that there was no correlation between the anatomical findings of the scan and pain intensity. So just because you have a full thickness tear does not mean your pain intensity will necessarily be higher. In fact, a more crucial point to take away from this information is that scan findings do not necessarily correlate to pain. For example, my own shoulder was scanned a few years ago and it found a large tear in the joint surface covering, thickening of ligaments, narrowing of spaces and all sorts however my shoulder has no pain. At all.
Scans need to be interpreted with a careful eye and this is where physiotherapists can help.
“Well if my rotator cuff is torn, then it doesn’t work and it needs to be repaired. So I should go and get surgery”
Not necessarily. A study by Kuhn et al. (2013) took 452 individuals with full-thickness rotator cuff tears and were considering surgery and put them through a 12 week program of physiotherapy exercise. Of the participants 75% elected to avoid surgical intervention as they had improved significantly in their pain and function. This 75% also tended to avoid surgery on 2 year follow-up as well! This study shows the power of exercise led by physiotherapy in managing rotator cuff tears and shoulder pain.
If you go to a GP and have a scan I implore you to seek help from physiotherapy to understand what the scan means. Furthermore, even with a full-thickness tear you still have significant hope as shown by research that you can make a recovery from pain even without surgical intervention. Come visit us at Mile End or Salisbury and we can help you understand what your scan results mean for you and what we can do about it!
Dunn, R et al, 2014, ‘Symptoms of pain do not correlate with rotator cuff tear severity: a cross-sectional study of 393 patients with a symptomatic atraumatic full-thickness rotator cuff tear’, J Bone Joint Surg Am, vol. 96, no. 10, pp. 793-800.
Kuhn, J et al, 2012, ‘Effectiveness of Physical Therapy in Treating Atraumatic Full Thickness Rotator Cuff Tears. A Multicenter Prospective Cohort Study’, J Shoulder Elbow Surg, vol. 22, no. 10, pp. 1371-1379.