Rotator cuff injuries are all-too-frequent in the United States, affecting millions of people throughout the population.
Research shows that rotator cuff injury is the most common form of tendon injury in older adults, with 30% of individuals over the age of 60 — and 62% of individuals over 80 — suffering from at least a partial tear; another study found that 22% of people of all ages have a complete tear. When faced with long-lasting pain, shoulder weakness, or decreased physical ability, those suffering from rotator cuff tears often elect to undergo rotator cuff surgery.
Unfortunately, shoulder surgery may not be the best option available.
In addition to the many potential complications associated with any kind of surgery (including hemorrhaging, infections, adverse reactions to anesthesia, etc.), some patients also experience nerve injury, permanent stiffness, and an increased likelihood of re-tear to the repaired tendons. The good news is that shoulder surgery alternative solutions are available that don’t require invasive procedures.
Here, we will examine some of the possible alternatives to rotator cuff surgery that may offer relief and improved mobility — from physical therapy and medications to lifestyle changes to new technologies that are revolutionizing the fields of sports medicine and orthopedics. But first, let’s take a look at what a rotator cuff is, and what happens to it when it gets injured.
What Is a Rotator Cuff?
The term rotator cuff describes the collection of muscles and tendons that work together with the deltoid muscle to secure the ball of the upper humerus bone into the shoulder socket and allow it to move freely. The rotator cuff depends on each of these muscles to function properly:
- Infraspinatus
The primary muscle in the shoulder; associated with rotation. - Supraspinatus
The muscle most responsible for stabilizing and securing the humerus bone in the shoulder socket - Subscapularis
A large muscle that assists in securing the upper arm bone to the shoulder blade. - Teres Minor
A small muscle that helps with arm rotation.
Tears and other injuries to these muscles and tendons often result in near-constant discomfort and limited shoulder/arm mobility. Exercises and stretches that target these muscles can help keep them strong, and using proper form when lifting and carrying items can also help reduce the chances of experiencing rotator cuff tendonitis and other types of rotator cuff injury.
What Is Tendonitis in the Rotator Cuff?
Tendonitis in the rotator cuff is characterized by inflammation of the tendons in the shoulder from strain or injury. Shoulder tendonitis is often seen among athletes who regularly participate in tennis, swimming, basketball, golf, and other ‘overhead sports.’
What Are Other Types of Rotator Cuff Injury?
The human shoulder is a complex biomechanical mechanism with many parts operating in tandem. And, as with any complex system, this means that there is a lot that can go wrong.
Besides tendonitis, common rotator cuff injuries include:
- Bursitis
Inflammation of the shoulders’ bursae (fluid-filled sacs that reduce friction and absorb impact in the shoulder joint). - Shoulder Impingement
Condition in which the rotator cuff rubs or catches on shoulder bones during movement, potentially leading to injury to the tendons. - Tendon Strain
Partial or full tears to the tendons on the shoulder, either as a result of repetitive motion or from a direct injury.
General wear and tear can increase the likelihood of experiencing the full range of rotator cuff injuries.
Common Causes of Rotator Cuff Injury
While direct injury to the shoulder (such as a dislocated shoulder or a broken collarbone) can easily damage the rotator cuff, the most common causes of rotator cuff injury are degenerative. Tendons naturally wear out as we get older and may also be affected by other age- and usage-related damage, including:
- Overuse
- Decreased blood flow from aging
- Poor posture
- Bone spurs
- Weak shoulder muscles
Symptoms of Rotator Cuff Injuries
There are many indicators of shoulder injury that patients and providers should be aware of. Common signs of rotator cuff damage include:
- Pain when moving the shoulder, especially when lifting the arm or pushing against an object
- Weakness in the shoulder, especially when lifting or rotating the arm
- Limited range of motion in the shoulder
- Grating, clicking, or popping sensations when moving the shoulder
- Visible swelling or tenderness in the shoulder area
- Difficulty sleeping from shoulder pain at night
- Pain that radiates down the arm
That said, one of the biggest hurdles to effective rotator cuff treatment is that often those suffering from shoulder injuries are not even aware of the cause; not every shoulder injury announces itself — research suggests that nearly 50% of tears may be classified as asymptomatic, but can still lead to further problems if left untreated.
Non-Surgical Alternatives to Rotator Cuff Surgery
Despite the pervasiveness of invasive surgical solutions when treating damaged tendons, there are several non-surgical rotator cuff repair options available. These range from traditional physician-directed exercise and medication to more technologically advanced techniques.
The most effective non-invasive treatments for rotator cuff injuries include:
SoftWave Therapy
Often, the most effective and least invasive solution to a rotator cuff injury is to allow the body’s own healing process to take the lead. SoftWave therapy uses low-intensity, broad-focused shockwaves permeated through the damaged tissue, kickstarting the natural regeneration processes at the cellular level—without harming surrounding structures.
A 2022 randomized clinical trial found that shockwave therapy significantly improved pain, shoulder function, quality of life, and reduced the size of calcific deposits in patients with calcified rotator cuff tendinopathy (Fatima et al., 2022). Participants who received shockwave therapy combined with routine physical therapy outperformed those on physical therapy alone across all major clinical outcomes.
Recent and ongoing research continues to reinforce SoftWave’s effectiveness in regenerative medicine, making it a trusted solution in treating rotator cuff injuries without surgery.
Physical Therapy
Building strength and flexibility in the shoulder following a rotator cuff injury is essential whether or not the patient elects to have surgery. A 2016 meta-analysis of surgery and conservative treatments for rotator cuff tears concluded that active physical therapy alone may be just as effective at reducing pain and restoring shoulder mobility as invasive techniques.
At the same time, physical rehabilitation carries with it substantially fewer risks and significantly lower costs when compared to surgery. The downside is that physical therapy may take months or years to begin showing results. As such, physical therapy is often used in conjunction with other forms of treatment.
Pain Management
When mobility is less of an issue, health providers may choose to treat the pain caused by the rotator cuff injury. In these cases, pain medication may help manage inflammation in the shoulder tissue. The medications used can range from standard over-the-counter NSAIDs (nonsteroidal anti-inflammatory drugs, such as ibuprofen) to higher-potency prescription pain relievers.
That said, long-duration use of any kind of painkiller can lead to issues such as dependency, lowered immunity function, cardiovascular problems, gastrointestinal issues, and damage to the liver and kidneys.
Corticosteroid Injections
For situations in which traditional pain management is ineffective, some care providers may opt to apply corticosteroids to the affected tissue. Corticosteroid injections offer near-instantaneous relief from localized inflammation.
Unfortunately, these injections tend to provide only short-term pain relief and are not generally considered reliable long-term solutions. Persistent use of corticosteroids in the shoulder can lead to weakened tendons and other side effects. Typically, health providers will only recommend corticosteroid injections to help patients overcome pain while engaging in physical therapy.
Platelet Rich Plasma Injections
A relatively new form of treatment, platelet-rich plasma (PRP) injections, are designed to increase the amount of platelet-rich plasma at the location of the injury. The procedure involves doctors taking a sample of the patient’s blood, using a centrifuge to separate and concentrate the blood’s platelets, and then reintroducing those platelets into the shoulder. Because blood platelets play a primary role in healing soft tissue damage, an infusion of plasma directly into the area of concern can speed recovery and promote improved tendon repair.
PRP involves plasma that comes directly from the patient’s body, so there is little risk of side effects. Still, some patients may experience increased soreness in the area being treated. There are also some risks associated with damage to veins, infection, and potentially even blood clots, though these risks come from the needles themselves and have little to do with the PRP.
When Not to Have Rotator Cuff Surgery
Rotator cuff surgery can be life-changing for some, but it’s not always the right solution. In fact, there are many cases where not having rotator cuff surgery may be the safer and more effective choice.
You may want to avoid surgery if:
- The tear is partial or small
Many partial tears can be managed with physical therapy, lifestyle modifications, and non-invasive therapies like SoftWave. - You’re over age 60 and symptoms are mild
Research shows that many older adults with rotator cuff tears experience no significant improvement from surgery compared to conservative treatment—especially when mobility and strength are mostly intact. - You have other health risks
Chronic conditions like diabetes, heart disease, or immune system disorders can increase the risks of surgery and slow down recovery. - The tear is degenerative and slow-progressing
In cases where the damage has built up gradually over time, non-surgical rotator cuff treatments often provide sufficient relief without the complications of surgery. - You’re unable or unwilling to undergo extensive rehab
Rotator cuff surgery often requires months of recovery and strict post-op physical therapy. If that commitment isn’t realistic, conservative care may be more manageable and just as beneficial.
Surgery is a tool—but it’s not always the best one. Exploring non-invasive options first, like SoftWave Therapy, gives patients a chance to heal naturally with fewer risks and more flexibility.
Treat Shoulder Injuries Without Surgery with SoftWave
Whether from sports injuries, accidents, or simply the natural wear and tear of aging, rotator cuff injuries are a source of concern for millions of patients throughout the US. But while surgical procedures may be effective in treating and repairing some of these injuries, the cost and associated risks of invasive procedures leave many patients and providers looking for an alternative solution. SoftWave is the answer.
For patients, it offers fast-acting relief, no downtime, and no surgical risks. There are no stitches, no anesthesia, and no lengthy recovery period. Instead of going under the knife, patients can return to their daily lives faster—with improved mobility, reduced pain, and lasting results.
For healthcare professionals, SoftWave adds value without adding complexity. You can offer your patients a proven alternative to rotator cuff surgery backed by clinical evidence. You’ll expand your treatment capabilities, improve patient satisfaction, and help people heal faster without introducing the complications, costs, or recovery burden associated with surgery.
Become a SoftWave Provider and contact us today to learn more. After all, shoulder injuries happen — but with the right non-invasive therapy, they don’t have to mean reduced quality of life for your patients.
