Kuhn (2023) reviews the prevalence, natural history, and nonoperative management of rotator cuff disease, synthesizing population data, progression studies, and treatment trials to answer how common tears are, who progresses, and whether surgery or physical therapy is the right first move.
When you see an older patient with a full-thickness rotator cuff tear on MRI, remember that tear size and anatomy do not reliably predict pain or function — start with structured physical therapy, counsel the patient that >75% avoid surgery, and reserve operative discussion for those who fail conservative management or have acute traumatic tears with functional deficit.
Kuhn (2023) reviews the prevalence, natural history, and nonoperative management of rotator cuff disease, synthesizing population data, progression studies, and treatment trials to answer how common tears are, who progresses, and whether surgery or physical therapy is the right first move.
When you see an older patient with a full-thickness rotator cuff tear on MRI, remember that tear size and anatomy do not reliably predict pain or function — start with structured physical therapy, counsel the patient that >75% avoid surgery, and reserve operative discussion for those who fail conservative management or have acute traumatic tears with functional deficit.