What is the current recommendation for rotator cuff tears in children? Leave them alone and see if they can heal on their own? Or do surgery to repair the damaged structures?

Reports indicate that more and more children are developing sports-related shoulder injuries previously only seen in the adult population. Rotator cuff tears are among those problems. Though uncommon, these incidences are on the rise.

Right now, partial-thickness tears of the rotator cuff in children and teens are treated conservatively (nonoperative care). Full-thickness tears may be better off with a surgical repair but this remains unproven as yet.

With so little data, so few studies, and the rarity of this injury, we simply don’t know if nonsurgical healing of rotator cuff tears is even possible in this age group. The surgeon may adopt a wait-and-see approach. If painful symptoms, loss of motion, weakness, and decreased function remain bothersome, then surgical repair may be considered.

With more and more sports injuries, the use of arthroscopic examination and treatment in this age group is on the rise. There are many advantages of arthroscopic surgery. Arthroscopic examination gives the surgeon the opportunity to carefully and thoroughly examine the shoulder. As a result, damage or injury to the shoulder structures that might have gone undetected is identified and treated.

With smaller incisions possible, there is less pain and stiffness following arthroscopic procedures (compared with open incision surgeries). Other advantages of arthroscopic surgery include shorter rehab time, a more cosmetically appealing result, and less postoperative pain.
And studies show that with arthroscopic stabilization of a chronically dislocating shoulder, there are fewer recurrences of dislocation after arthroscopic surgery compared with nonsurgical treatment.