Torn rotator cuff...

My brother has recently received confirmation via an MRI that he has a partial tear - a fray, to be specific - of his subscapularis. He still has pretty good range of motion, but his shoulder gets enflamed if he tries exercising, so he has pretty much quit most upper body activities.

He's worried that he might need surgery. Has anyone out there had similar injuries? Any advice I can relay to him? It would be much appreciated.
Thanks!

surgery was a breeze recovery was 16weeks long first 4 no movement of arm 2nd month slowly start working range of motion and so on no real pain to speak of just make sure to do all the therapy shoud be fine.

Sounds like something that can be taken care of with orthoscopics, meaning they go in through a small incision and healing is pretty quick...

If you do what I did, wait year while your on probation at a busy Fire Department, it will turn into a major surgery with a long recovery time and change your life forever...

  Get the surgery now....  my 2 pesos...

He can try physical therapy first if he doesn't want to go the surgery route.  If you build up the supporting muscles, then they act as a natural brace to keep the two joints from banging into each other ( that's what causes the pain and inflammation).  Best thing to do is to get a professional to guide him through the exercises, otherwise look up theraband and the associated exercises to build up the correct muscles. 

Agree with Danglin.
Whatever he does, do it now- get professional advice, and don't wait.

I waited what turned out to be weeks and decades, now I'm f'in hobbling around for an entire fall and winter trying to heal

The MRI didn't see mine.
They did a subacromial decompression the first go around. All it did was hurt and cost me money and sick leave.
The second go around they said that they did an MRI during surgery and found I had a 90% tear.
Can't really paddle anymore. Thanks goodness for Hobies.
I don't think it will ever be right.

I have torn rotator cuffs in both shoulders and have repeatedly re-dislocated both of them multiple times.  The good news?  I did it about 10 years ago and I never could get the time off for two shoulder surgery so I just lowly rehabbed it myself.  I went to two surgeons, one recommended surgery on both shoulders, the other said, "You might want to try and let them heal naturally".  I elected to try and see how they healed.

They both feel about 90% now and I can do pretty much anything I want, till I feel that "OMG ITS GOING TO POP OUT FEELING!" then I stop what I am doing and go drink a beer.

It's not all hopelessness.  Tell him it will get better for sure, but it is a long process.

I had the 90% tear on my left.  My right had been allowed to heal naturally from an ancient dirt bike mishap.  When I started paddling I could get through a strenuous day, take some aleve and deal with the pain.  However two days in a row was murder.  Had the surgery on the left.  Rehab was a bitch but I went relentlessly.  Now I wish I had had the right done years ago.  And yes---Hobies have become my go to ride.

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both sides for me, surgery and no therapy in 1974 when I was 17, never had trouble with it since. Cant throw a ball hard or lift heavy over head like a military press. The other one two surgeries, was ok for years after first then one day popped out. 2nd surgery recovered fine with therapy and then one day just went bad with pain and hasnt been the same since. has the same weak over head feeling as if it will pop out. So, surgery works most of the time. I think therapy is VERY important.

Strength exercises. Do all the ones that don't hurt.

http://www.optimumclinic.ca/moveo/wp-content/uploads/2012/09/Moveo_Buchberger12Exercises.pdf

More in depth discussion here:

http://www.irongarmx.net/Articles/7_minute_rotator_cuff_solution.pdf

Follow up with SMR work- or self myofascial release. He will need a lacrosse ball. A tennis ball will work in a pinch.

Really comes down to choice.  Remember that even a successful  shoulder surgery doesn't mean you will be 100% of what you were before.  I am going through the PT right now. It is amazing how well it works sometimes. I have had a 'bad'shoulder for over 30 yrs from a work injury.  I chose the PT route, because if surgery didn't work, I was out of a job.  Risk vs reward.  I am also looking to change to  a Hobie  from my current Cobra fish n dive.  Good luck to your brother.

To be more clear,

My shoulder was induced by trauma, a 35' ladder came down on me. I should have got the surg, but was afraid of getting surgery on probation, and there ya go... ouch...

Pt and therapy was a total bitch as they reconstructed my shoulder...  when I started having pain with my right shoulder, normal wear and tear for older active guys,  the therapy bands and exercises I learned did help and I never did need surg on that side...

2 more centavos....

Nathan had a "career ending" shoulder injury that the docs did not want to operate on because of his youth, still growing.  He went to a PT and fanatically followed the regime.  He is still competing and stronger than ever.

IMO surgery is always the last resort

IMO surgery is always the last resort

Agree, PT, Rehab, Get a Hobie, Get an AI, Get a PB THEN concede the surgery. 

I have had torn rotator cuffs in both shoulders from removing and installing Police Harley Davidson run flat tires when I was working (retired now).  I was offered surgery on both shoulders but declined and my range of motion is almost as it was before I had torn the rotator cuffs.  I did not have any rehab but instead of removing and installing the tires by myself I would get someone to help.  There were two other guys at work that had torn rotator cuffs, both had surgery, one guy came out ok and the other guy still has problems. 
Like someone else above mentioned, thank God for Hobies!