Rotator Cuff Tear Treatment in Amman

What is a rotator cuff tear?

The rotator cuff is a group of muscles whose tendons wrap around the top of the upper arm bone and keep the ball of the shoulder centred as you lift and turn the arm. A tear may be partial, through part of the tendon’s thickness, or full-thickness, through the whole tendon. Most tears develop gradually as the tendon changes with age, often without any injury, and they are common even in people with no pain. Less often a tendon tears suddenly after a fall onto the arm, a shoulder dislocation or a strong pull, and this can happen at any age.

Common signs

Pain at the top or outer side of the shoulder that may spread into the upper arm, often worse at night or when lying on that side
Weakness or tiredness when lifting the arm, reaching overhead or turning the arm outwards
Difficulty with daily tasks such as combing your hair, putting on a jacket or reaching a high shelf
After a sudden tear: new weakness straight after the injury, so that lifting the arm on your own becomes hard or impossible

Common misunderstandings

"A tear on the scan means I need surgery": tears linked to age are common even in people without pain, and the decision depends on your symptoms, strength and examination, not on the scan alone
"A torn tendon cannot get better without an operation": for small tears that develop gradually, research suggests that surgery may add little benefit for pain and function compared with a structured exercise programme
"I will wait a few months to see if the weakness after my fall goes away": a sudden tear with new weakness after an injury, especially in a younger or active person, should be seen by a doctor soon, because an early surgical opinion may matter

What usually helps?

It depends on the type of tear. For tears that develop gradually, the core is a graded exercise programme that strengthens the remaining rotator cuff muscles and the muscles around the shoulder blade and shoulder, often starting in supported or lying positions and moving on to lifting the arm in standing and overhead. We add load in small steps as the shoulder copes, adjust for a while the activities that irritate it without stopping movement altogether, and may use manual therapy alongside exercise to help ease pain and stiffness. Most of the research on exercise has been done on this gradual type of tear. A sudden tear after an injury with new weakness needs a doctor’s assessment soon, and the doctor or orthopaedic surgeon decides on imaging and on whether a repair is needed. Injections and surgery are always the doctor’s decision. After a surgical repair, rehabilitation follows your surgeon’s protocol: usually the shoulder is protected first, then movement is restored gradually and strengthening comes later, with the timing set by the surgeon.

How we treat it at Revibe

We listen: how the pain or weakness started, whether there was a fall or injury, any scans or surgery, and what you need your shoulder for at work and at home
We examine shoulder, neck and shoulder blade movement and the strength of each movement, and identify what needs a doctor’s review or imaging soon
We identify what may slow recovery or keep the pain going, such as weakness of the surrounding muscles or heavy repeated loading
We treat: manual therapy and joint mobilisation, release of muscle knots around the shoulder and neck, and exercise therapy; after a repair we follow your surgeon’s protocol
We progress with a graded home exercise programme and a gradual return to work, sport and overhead tasks

When do you need urgent medical care?

Shoulder or arm pain, especially on the left, with chest pain or pressure, shortness of breath or sweating — go to the emergency department or call an ambulance: 911 in Jordan or 122 in Iraq and Kurdistan
A shoulder that looks deformed or out of place after a fall or injury — go to the emergency department straight away; suddenly being unable to lift the arm after an injury — see a doctor the same day
A hot, red, swollen shoulder with fever or feeling generally unwell — see a doctor the same day
Severe constant night pain with unexplained weight loss, a lump or a history of cancer, or new pain and stiffness in both shoulders or in several joints
Numbness, tingling or weakness spreading from the neck down the arm or into the hand

In these cases go to the nearest emergency department or a doctor straight away — instead of booking physiotherapy.

FAQ

Will I need surgery for a rotator cuff tear?

Not necessarily. Many people with tears linked to age improve with an exercise programme, and the decision about surgery belongs to the orthopaedic surgeon. It is usually discussed early after a sudden tear with weakness, especially in a younger or active person, or when pain and weakness persist despite a good exercise programme.

Do I need an MRI or ultrasound scan?

Not always at the start. A scan is usually considered when a sudden tear after an injury is suspected, when surgery is being considered, or if things do not improve as expected, and the doctor decides on it. We refer you when the assessment shows a reason to.

Should I rest my arm completely and stop moving it?

Long complete rest is usually not recommended outside the protection period after surgery, because it can make the shoulder stiffer and weaker. We keep the shoulder moving within comfortable limits and build strength gradually.

How many sessions will I need?

It depends on your condition and its stage; after the first assessment we explain the plan and the expected number of sessions.

More common questions: Shoulder pain questions — 23 questions