Sydney shoulder Surgeon Professor George Murrell reported some interesting findings at a conference I attended where he had called back all his patients 8 years after reconstructive surgery to assess how their shoulders had lasted via ultrasound and MRI.
Amazingly, 80% of them had RE-TORN their tendon!
What was interesting? Nearly all of these people were pain free, without any movement problems!
This little piece of news reinforces what I've thought for many years now: Radiology is helpful sometimes but it's not everything. Although these people looked bad on ultrasound, their shoulders were doing fine for them. I'm sure many people that come in to me with a sore shoulder and resolve quickly would have tears if investigated.
Effective Physiotherapy, by increasing range of movement via manual therapy, will almost certainly decrease someone's pain, in this case in the shoulder.
Of course, with structural damage this is not always possible and that's where injections and/or surgery should be considered.
But Physiotherapy's worth a try! I saw an old bloke last year who hadn't moved his arm for twelve months after a failed reconstruction. In his rotator cuff he had ruptured supraspinatus, ruptured subscapularis and partial tear to infraspinatus. That is, he only had 1 and a 1/2 muscles out of four!
His GP referred him in desperation for pain relief but after a few months he had 150 degrees of active flexion (to a high shelf) and virtually no pain.
To be honest, I was as surprised as he was!
