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Q. Is surgery mandatory for a muscle tear?

Answered by
Dr. Wesley Turner
and medically reviewed by Dr. Divya Banu M
This is a premium question & answer published on Aug 04, 2019 and last reviewed on: Sep 16, 2020

Hello doctor,

I suffered an injury in the right shoulder region four months back by falling off a fast speedboat. I was wearing a life jacket and buckles on impacted shoulder and I believe my arm was pulled back. It bruised badly. It is painful in some range of motions and have started back at the gym and hurts when under load on an exercise like pec dec. I went to an osteopath who reported below:

During an examination, there was pain on lateral flexion of his right shoulder. On observation, during right lateral flexion of the shoulder, his pectoralis looked atrophied and unsymmetrical compared to the left. On palpation, he was very tender on his right pectoralis major tendon and lateral muscle belly. I have therefore diagnosed him with a right pectoralis major tendon and muscle tear.

I have just received results from an MRI. My questions are:

What treatment should be done? Should I continue to exercise and slowly build up weights? Would it require surgery?

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Hi,

Welcome to icliniq.com.

Treatment should be very low weight and high reps for building strength and physical therapy would be highly recommended. Surgery for rotator cuff tears are determined on a case by case basis by orthopedic surgeon and usually based on age, pain and restrictions. In this setting with multiple issues on MRI findings and abnormal physical exam findings, surgery may be warranted.


The Probable causes:

Trauma from accident.

Investigations to be done:

None further - needs ortho referral.

Differential diagnosis:

Rotator cuff tear, arthritis.

Probable diagnosis:

Rotator cuff tear, labral tear.

Treatment plan:

Physical therapy, orthopedic surgeon referral.

Preventive measures:

Continue to lightly use shoulder, avoid heavy lifting.

Regarding follow up:

Follow up with ortho surgeon for surgical evaluation.


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