The E3 Rehab Podcast 208. Large to Massive Rotator Cuff Tears w/ Kathryn Fahy
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Jul 8, 2025 In a deep dive with Kathryn Fahy, a leading physiotherapist and recent PhD graduate, the discussion centers on large to massive rotator cuff tears. They explore the differences between degenerative and traumatic tears while emphasizing personalized patient care. Kathryn introduces her 'Calmer Cuff Pathway' treatment algorithm, highlighting the need for effective pain management and collaborative decision-making. The conversation also addresses rehabilitation strategies and the importance of patient education in enhancing recovery outcomes.
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Defining Large Massive Tears
- Large to massive rotator cuff tears are defined as tears over 3 cm involving two or more tendons.
- Surgical considerations include fatty infiltration and tendon retraction, but clinicians mainly assess size and tendon number.
Conduct Thoughtful Initial Exams
- Conduct a thorough clinical exam checking red flags, instability, stiffness, and function.
- Make the assessment more of a conversation to uncover key info that might arise later.
Degenerative Tears Prevail in Older Adults
- Degenerative tears increase with age and are common in older adults, while traumatic tears are rarer.
- Around 1 in 10 tears in this cohort are traumatic, often requiring different management.