Why Didn’t My Rotator Cuff Heal?

Healing of a rotator cuff is complicated and depends on a number of variables. Many rotator cuff surgeries will heal just fine, but others may not. The simple explanation is the shoulder is a difficult place for healing to occur, and the rotator cuff itself is a complex area.

Here are some more specific reasons why a rotator cuff didn’t heal.

Main Reasons A Rotator Cuff Doesn’t Heal After Surgery

rotator cuff painAge is a major factor

The tendons connected to the bone begin to wear out starting at about age 30. This “wear and tear” factor varies by person, but by age 50 most everyone has some degree of degeneration which can cause a tear without any real trauma. This is sometimes called an “attritional tear.”

The size of the tear and the amount of damage affects the healing

The chance of healing is in direct relation to the depth and size of the tear. Consequently, the larger the rotator cuff tear prior to surgery, the higher the rate of failure after surgery.

Aggressive physical therapy may contribute to a rotator cuff that doesn’t heal well

If a patient returns to all their activities too quickly, this may be detrimental to healing.

If the therapy causes a lot of pain, the therapist may need to slow down the pace. Talk to Dr. Koo if you are experiencing pain during and after therapy sessions.

Although patients might be encouraged to return to activities before six months after surgery,  most surgeons today suggest that it takes nine months to completely heal from rotator cuff injury and surgery.

Healing A Rotator Cuff With or Without  Surgery

Many tears don’t require surgery. In these situations patients may undergo injections, physical therapy, and take anti-inflammatory medications. Similar issues apply for tears without surgery.

The cause of the tear is an important factor. Was it from degeneration or an injury?

It is believed that degeneration of the tendons is the main reason a rotator cuff does not heal, and the older the patient, the more deterioration. Consider an old pair of jeans that eventually develops a hole in the knee. It is difficult to repair due to the frayed edges.

How long the tear has existed also can affect if and when it heals.

Healing a rotator cuff injury involves many variables. If you have any questions, or would like to schedule an appointment in the Seattle, WA area, contact Dr. Samuel Koo at (425) 823-4000.

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COVID-19 Update

4/21/20 Update: Effective immediately, Dr. Koo is seeing patients through telehealth visits and in-person visits at our clinic. Call today to schedule your appointment!

Dr. Samuel Koo is closely following the most up-to-date announcements and information on the known cases of Novel Coronavirus (COVID-19). Because this information is always changing, we will be monitoring all updated from the World Health Organization and Centers for Disease Control.

To better serve you, Dr. Koo is now proud to offer virtual visits. With telehealth, you can meet with Dr. Koo from the comfort and safety of your own home. Please call our office today to learn more about this service or to schedule an appointment.

As of last Friday the governor of Washington state issued a declaration that all non-urgent or emergent surgical cases be postponed until the week of May 18th. For more information, please reach out to our office at (425) 823-4000.

Here are a few additional resources as well:

World Health Organization
Centers for Disease Control