Can you hold your arm out to the side or does it drop down? Elderly individuals have been known to have tears in this location and have trouble holding their arm out at the side more than 45 degrees. But they (most) don't swim. What are your symptoms?

Yes, I'm having trouble lifting and holding my right arm out to the side and pain while sleeping on that side.

Get it fixed! I had a supraspinatus, subscapularis, and labrum tear, plus a partially shredded bicep tendon. It was incredibly painful and debilitating. I had surgery on May 1, PT twice a week since day 10 after surgery, and just got back in the pool last week. I definitely recommend getting it fixed and I wish I had pushed for it sooner rather than put up with 6 months of pain and weakness.

Thanks

Partial tears, even high grade, do not need to be fixed. Many people have tears like that, don't know it and are incredibly active. I would try PT to strengthen the remaining cuff and see how it felt. If painful, surgery, if not , leave it. There are a lot of misinformation about partial tears so make sure you see a good/ethical ortho

Thank you!

You had PT twice a week for 4 months? Wow, that seems like a lot of PT. How is your shoulder doing now? I'm going to the Orthopedic doc this Monday. I did PT for the last 6 weeks and my shoulder is not getting better.
Thanks,

I still have 2 PT appointments left! The doc gave me a total of 6 months, plus I had a month prior to surgery too just to see if that would help it before the decision to have surgery. It's been very expensive but worth it. I'm lookign forward to getting al that time back when I dont' have to go anymore.

Shoulder is doing great. I don't have all the strength back but I can swim and have full range of motion. It's not 100% yet in some ways but it takes a long time for some of the repairs to heal.

It sounds like you are doing really good. It seems like a long rehab process. My PT is trying to get me as strong as she can before surgery. She said I should heal quicker. I'm not looking forward to surgery and the rehab but it looks like I have no other choice.

Thanks for your help,

Thread over- this is the best advice you're going to get (via the internet, anyway). I did general ortho/sports for a few years- helped fixed many, many cuff tears (I'm a Physician Assistant currently doing total joints fwiw).

My tear is a "high grade tear". I looked up high grade tear and it said that it's a 50% or greater tear of the tendon. I haven't seen an Orthopedic Doc yet but my friend who is a doctor said that the average person probably wouldn't get this fixed but since I'm so active, he thought I should. Any thoughts? Thanks for you post. I really don't want surgery but I'm in PT right now and it's not getting any better.

I would give PT a few months, and if no improvement then would consider surgery

It's a tough call..particularly over the internet. My old boss used to say there are MLB pitchers throwing 90mph fastballs with partial tears. If it's me, I'm probably doing PT, switching to a bike/run focus, and giving it a solid 9-12 months to declare itself. Quality of life definitely factors in- not your ability to do tris, but your ability to sleep/lift your arm without pain. I'm curious as to whether the difficulty lifting is true weakness or pain-feedback inhibition (hurts like hell, don't wanna do it).

Further clouding the issue- MRIs aren't perfect. I've seen radiologists read partial tears that are full-thickness tears is the OR- and I've seen them read partial tears for no tears at all- redundant soft tissue causing an overread. The latter is great- typically about 75%+ of patients feel better, and all we've done is a shoulder gargle with a bit of debridement.

If your doc does recommend surgery- the first question I'd be asking is does he/she do arthroscopic repairs versus mini-open? If arthroscopic, how often do they have to convert to mini-open? I definitely drink the koolaid when it comes to arthroscopic repair of RC tears. In 2 years, we converted to mini-open only once. We did about 5 RC repairs a week (we were general ortho...but my boss was pretty damn good at shoulder scopes IMO). Some docs will tell you a subscap tear needs to be repaired properly through a mini-open. That's bullshit IMO- they just can't run a 70 degree scope properly (to visualize the subscap). My point? Find a fellowship trained sports med doc if you go the surgery route. You want someone who does high volume- usually a knee/shoulder guy who scopes all day long.


Hope this is somewhat helpful. Things get a bit grey when we are talking about partial tears.