Management of Partial Thickness Tear of Supraspinatus

Initial Non-Surgical Management

The American Academy of Orthopaedic Surgeons recommends initial management of partial thickness tears of the supraspinatus with non-surgical treatment, including physical therapy, for tears involving less than 50% of tendon thickness 1
Physical therapy is the first-line treatment to improve strength, flexibility, and function of the shoulder 2
Anti-inflammatory medications can be used concurrently with physical therapy to manage pain and inflammation 2
Corticosteroid injections may provide temporary relief for inflammation and can be used alongside other non-surgical treatments 2
Activity modification is recommended to avoid aggravating movements during the healing process 2

Presence of muscle atrophy and fatty degeneration in the supraspinatus correlates with worse outcomes and healing potential 1
Patient factors such as age, activity level, and severity of symptoms should guide treatment decisions 2
Workers' compensation status correlates with less favorable outcomes after rotator cuff repair 1

Surgical intervention is indicated when conservative treatment fails after 3-6 months 2
Patient has significant functional limitations 1
Surgical options include arthroscopic, mini-open, or open repair approaches (no specific technique has proven superiority) 3, 2
Acromioplasty is not required for normal acromial bone (including type II and III morphology) during rotator cuff repair 3, 2
The primary goal of surgery should be to achieve tendon-to-bone healing, which is associated with improved clinical outcomes 3, 2

Post-surgical recovery typically requires wearing a sling for 4-6 weeks 2
Rehabilitation program lasting several months is essential for optimal recovery 2