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Non-surgical recovery after rotator cuff rupture

March 2021

RF is a right-handed 77yo semi-retired house painter, whose work resulted in left shoulder pain and a left rotator cuff repair in 2002. His shoulder recovered well, but he fell from a ladder in early 2020, resulting in a left shoulder dislocation, axillary nerve injury, and full thickness tears of the infraspinatus and supraspinatus (rotator cuff) tendons. His surgeon was considering a total shoulder replacement, but they agreed to trial some physiotherapy treatment for a few weeks instead. He first attended Flex Physiotherapy in April 2020.

This patient was highly motivated, performing his exercises twice daily – first at home and later in the gym. His pain settled within a month, and his shoulder motion and strength improved gradually over a 9-month period. He and his surgeon soon concluded that he would be better off without further surgery.

The first graph shows his shoulder elevation range of motion improving from 65° last May to 145°, and the second chart shows his Deltoid muscle strength. This was measured with a dynamometer to track the recovery of the axillary nerve, and it increased from less than 2kg to 10.5kg – almost equal to his uninjured right arm.

RF was discharged from physiotherapy this week. He has no pain, is continuing to exercise regularly, and has successfully returned to interior house painting.

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