Rotator cuff tear 2010 found no solid evidence that rotator-cuff surgery benefited people more than nonoperative management. Those with pain but reasonably maintained function are suitable for nonoperative management. This includes oral medications that provide pain relief such as anti-inflammatory agents, topical pain relievers such as cold packs, and if warranted, subacromial corticosteroid/local anesthetic injection. An alternative to injection is iontophoresis, a battery-powered patch which "drives" the medication to the target tissue. A sling may be offered for short-term comfort, with the understanding that undesirable shoulder stiffness can develop with prolonged immobilization. Early physical therapy may afford pain relief with modalities (e.g. iontophoresis)
Glenohumeral ligaments capsule is strengthened in front by two bands derived from the tendons of the Pectoralis major and Teres major respectively. During abduction of the arm the middle and inferior ligaments become taut while the superior ligament relaxes. The radius of curvature of the head of the humerus is greater superiorly than inferiorly, which further stretches these ligaments so that they keep the articular surfaces of the joint in their close-packed position. During abduction the greater tubercle of the humerus comes in contact with the upper margin of the glenoid cavity, which limits maximum abduction. By rotating the humerus laterally, this