Patients with massive irreparable rotator cuff tears are a fascinating group of patients. They typically present with shoulder pain and inability to raise the arm above shoulder height and the resultant disability has a huge impact on everyday activities and quality of life. The intriguing thing about these patients is that some of them have a very successful result from physiotherapy exercises and regain good functional movement of the affected arm. However some do not improve at all and often need to have arthroplastic surgery.
It is not easy to predict who will be a good responder to physiotherapy and indeed there has been a lack of consensus on what is the optimal physiotherapy programme. My talk describes my PhD journey through the literature and my own research on this topic with a strong clinical focus to guide clinicians on what we should do in clinic.
It will cover:
- What are massive irreparable rotator cuff tears?
- radiological features, patent characteristics, biomechanics
- What are the treatment options?
- Surgical & non-surgical
- Challenges of clinical decision-making?
- Physiotherapy programmes?
- Content, evidence, efficacy
- What are the prognostic factors for success with physiotherapy?
- Results of our international Delphi study
- Targeted physiotherapy assessment & intervention and practical demonstrations
- Questions and discussion
