Tune in to Dr. Kuntz's Informal VLOG, full of connections with other professionals and additional tips on how to stay healthy! Located in Ballantyne | Charlotte | North Carolina
What Would You Like Dr. Kuntz To Talk About?
All right, so this is a super hot topic for me, because it seems so profound to me that so many people will elect for shoulder surgery, particularly for a rotator cuff tear, more so than any other joint of the body that I've seen. You know, I might be able to talk to someone and educate them about the neck, about the low back, about the hip, about the knee and how we can potentially help them. And to most people seems like it makes sense to them, "Hey, I can work with someone conservatively, no more corticosteroids, no more surgery, and let's see between 6 to 12 weeks if I can recover." Now, when we get to the shoulder, it just seems, in my experience, so many people assume that they need a rotator cuff surgery. I'm not quite sure why a majority of people tend to think that way, and they assume that they need surgery, and they assume it'll be like a miracle cure and work for them and they won't ever really need to do work again. But I'm here to tell you that's not true. And I'm here to kind of just show you a little bit more of the science and the data behind it.
So just to get into this in a quick review, there are four rotator cuff muscles, the supraspinatus, infraspinatus, teres minor, and then the subscap that sits underneath it. Now more times than not, if you have a rotator cuff tear, it's going to be a supraspinatus, all right? That's the number one muscle that usually has rotator cuff tear. And then secondarily would be an infraspinatus. Thirdly, usually it will be the teres minor, and it's an absolute massive rotator cuff tear. You might even have a tear to the subscapularis.
And then, you know, rotator cuff tears can be quantified into the length of the tear that they'd have in terms of the length that it shows. And then in this view, it's a better angle to show you that we can also have a tear through the depth. Now, I don't need to get to the grading scales or anything like that. I just want you to have a general idea what that looks like. So let's get into the science and a little bit of the background. Now, this is a great infographic, who was a gentleman, by Lee Darren H., so just shout out to him. I am using his content. He created this.
And it just gives us a great idea about one particular study, and I'm going to show you another one in a second, regarding findings in the shoulder. So, this particular research study was an ultrasound, and they looked at 51 men, who, by the way, did not even know they had anything wrong with their shoulder. These are men that felt great. They had no pain or problems in their shoulder. They put them through an ultrasound. What they found is that 22% of the time they had a partial rotator cuff tear, but these men were pretty surprised that they had these tears in their shoulder, because they were probably feeling no pain. Secondarily, 78% of them had kind of a form of bursitis or a bursal thickening, okay? And then almost 100% of the time, almost everyone that went in to this ultrasound, they were able to find some abnormalities, they were able to find something that would probably give a surgeon a reason to go in and to do surgery. Just quite profound. Another really cool study I want to walk you guys through, and this one was called The Effectiveness of Physical Therapy in Treating Atraumatic Full-Thickness Rotator Cuff Tears.
So that first word up here, you know, atraumatic, atraumatic just meaning these people did not have any trauma, they didn't even know that they are having injuries or that they had some form of an injury in their shoulder. So this is pretty cool. Check this out. So 452 people, 452 people, so that's quite a bit. They have atraumatic full-thickness tears. That's a lot of people. It's a great sample size, and all these people had a rotator cuff tear. In fact, it was full, okay? They elected for a physical therapy program that lasted between 6 to 12 weeks, okay? At the end of the 12-week program, for those who went through it, 75% of the people avoided surgery, 75% of people avoided surgery. And if they did need surgery, they pretty much knew it right around the 6 to 12-week time frame.
Very few had surgery between 3 and 24 months. What does that tell us? It tells us that we know pretty quickly within three months whether or not your particular full or partial rotator cuff tear is going to be successful with a hands-on program. So let me just ask you this, you know, is it worth it to you to consider, "Heck, I'll even just put up four weeks"? Just give us, you know, give four weeks, four to six weeks of a conservative program to see if you can avoid surgery. And here's a trick, too. You will most likely almost guaranteed need some form of rehab program to address your rotator cuff after, all right? So I'm gonna just pull up a video here showing you some movements. But you will almost absolutely need to do some form of rehab even after the surgery. In fact, I can tell you right now the road is much longer, much longer if you go through surgery.
So, isn't it worth it? I had to make this video today, because just it seems so profound that so many people want to go right into surgery and avoid the work. But I'm here to tell you science and research is actually behind your side. We've already looked at the data and made sure that it's not something else that's causing your pain in the shoulder. In fact, a lot of times I see, you know, tight upper traps, I see a tight neck that can be involved. I can see limitations anywhere in the lower spine, even in the elbow or hips. That's why it's so important to have a very clear understanding of what's causing that shoulder pain, as opposed to just going underneath the knife. I hope that makes sense, guys. Thank you so much.
Rotator Cuff Pain | Rotator Cuff Exercises | Physical Therapy for Rotator Cuff