I injured my rotator cuff last summer playing on a community baseball team. I have seen three surgeons and gotten three different answers about how to treat the problem. How’s a patient supposed to decide what to do?

You ask a good question that may not have a good answer. Variation in opinions about treatment of rotator cuff tears (RCTs) is common among surgeons. As you’ve seen it’s common among the doctors in one community. It’s also common across the United States.

There are many reasons for this variation. According to a recent study surgeons base their opinions on different factors. They may go on the basis of how many operations they perform each year. The more experienced surgeons see things differently than less experienced surgeons.

Research hasn’t helped much either. Studies don’t show one treatment method works better than any other for RCTs. There’s both a lack of evidence and mixed results reported.

One way to manage your own care is to start with a conservative approach. Options to try include cortisone injections, anti-inflammatories, and/or physical therapy. A rehab program may be all you need to recover your strength, motion, and function.

If those things don’t work, then you can think about having an operation to repair the damage. Your decision may be based on how serious the injury is and how quickly you want results.