Mr Simon Lambert BSc FRCS FRCSEdOrth

Consultant Orthopaedic Shoulder & Elbow Surgeon

Complete tears 

Complete tears of the rotator cuff (RC), most commonly of the supraspinatus (SSP), present themselves with painful weakness of specific movements, such as reaching forwards or sideways from the body. This will have different consequences for each individual, depending on the position and size of the tear, and the function that is needed from the tendon. 

It has been long established that repair of a torn tendon, if possible, is the best way of treating the pain of the tear - providing the tendon heals back to the bone. It does not matter how the surgery is performed (whether by open surgery or arthroscopic [keyhole] surgery) providing the repair is sufficient to hold the tendon on the bone long enough for it to heal. This takes about three months: that is to say, the initial stages of repair take about six weeks by which time the tendon will be stuck to the bone by the healing scar response but the strength of the healed area would not bear the raised arm without support. By three months the scar tissue response is much better and stronger so that simple activities close to the body are possible without danger to the repair.

It typically takes six months for the scar tissue of repair to mature sufficiently for the arm to be moved away from the body without support into a greater range of movement.

Some argue that the strength and quality of the repair is better if the arm is moved at an early stage after repair (so-called “accelerated rehabilitation”), while others say that the quality of the repaired tendon is better if the arm is rested for the first six weeks: whatever the case (which still has to be proven clearly) the outcome for each approach appears to be the same by six months - providing the tendon heals.

Related treatment information:

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