There it was, the research paper that made us question if surgery was the answer to all muscle and ligament tears. Before then we rarely questioned if we needed surgery for a tear.
Are most surgeries done for no reason? No, sometimes you really need it to help you have a better quality of life (nevermind getting back to your sport). What the paper did shed a light on was that some injuries can improve from only doing rehab.
Surgery does come with risks that rehabilitation exercises don’t have to worry about. Usually, after surgery, rehab is suggested as the last step. So all we are doing is skipping to the last step to see if that will make a difference.
That doesn’t mean that if rehab alone is not successful that surgery can’t be done after. It most definitely is an option. The downside is wasted time from having to wait for the surgery and do the rehab a second time.
On the other hand, you’ll save time if you try rehab first. Maybe it’s worth a shot then?
The times where I’ve sent clients in for a consult is when shoulders have kept dislocating more frequently and easily over time. Other times are when rehab was not improving symptoms and quality of life was affected.
What we don’t have the answers for are whether it’s worth the risk to avoid surgery when were dealing with an athlete/athletic individual. Will they be at risk of causing long-term damage to the joint if they don’t get the surgery or is has the damage already been done? Will they feel confident to continue their sport? Will they feel confident to continue after the surgery (sometimes no)?
What makes the decision difficult is that while we make the decision now, we don’t know what could happen in 10 + years from now.
We’ll still need more research papers to help us consider the no surgery route in many other cases, but it gives us more options in some cases to get back to our lives faster.