Nonoperative treatment of rotator cuff tears

Rotator cuff tears and subacromial impingement are second only to acromiocl avicular joint disorders as the most common causes of shoulder pain. Althou gh most orthopedic surgeons are willing to initially treat shoulder impinge ment syndrome conservatively, they are reluctant to manage rotator cuff tea rs-especially full-thickness tears-nonoperatively. The purpose of this arti cle is to explain the biomechanical rationale of nonoperative treatment, re view the literature pertaining to nonoperative treatment of full-thickness rotator cuff tears, and describe a nonoperative treatment program.