Why a therapy addendum beats a rewritten first-visit history
A first-visit history answers: what happened, when did it start, what does the scan show. A therapy addendum answers a different question: what has already been tried, and what did it achieve. Mixing the two produces a long narrative that buries the decision-relevant facts. The receiving clinician has to reconstruct which symptoms predate treatment and which appeared afterwards.
For a rotator cuff tear, that distinction matters. A tear seen on imaging is a structural finding. Whether it is repairable, and whether surgery is the right next step, depends on the tendon and muscle quality, the tear pattern, your function, your goals and your response to non-operative care. If your addendum simply says 'physiotherapy did not help', the clinician cannot tell whether the programme was appropriate, whether it was completed, or whether the shoulder genuinely failed to respond.
So the addendum is not a courtesy summary. It is the part of the file that lets someone weigh previous shoulder therapy against repair and against continuing non-operative treatment. Keep your original history intact and attach this as a clearly labelled section.
What the addendum must contain, item by item
Write it as a short structured document, not prose. Each item should be answerable in one or two lines. If you do not know something, write 'not known' rather than leaving a blank, because a blank is ambiguous between 'nothing was done' and 'records are missing'.
Cover the therapy itself first: the type of treatment, the start and end dates, the number of sessions or the duration, and who provided it. Name the setting if you can, for example a hospital outpatient department, a private clinic or a home programme. Then cover what was actually done, in the terms your provider used, without translating it into a diagnosis.
Next, the response. Record pain, movement and strength separately, because they do not always move together. State whether the response was sustained after the programme ended or faded when it stopped. Note any adverse reaction, increased pain or interrupted course, and why it was interrupted.
Finally, the evidence. List the documents that support each statement: clinic letters, discharge summaries, therapy notes, imaging reports and operation notes if there was any surgery. A statement without a supporting document is still useful, but label it as your recollection.
- Therapy type, provider type, start and end dates, number of sessions or duration.
- What was performed, in the provider's own terms.
- Pain, range of movement and strength before and after, recorded separately.
- Whether any improvement persisted after the course ended.
- Any adverse reaction, worsening or reason the course stopped early.
- Documents that support each statement, and which statements are recollection only.
Tear size and tendon findings: what the China team needs alongside the therapy record
Previous therapy is only half the picture. The other half is the structural evidence, and it needs to be presented in a form a surgeon can interrogate. That means the actual imaging, not just the radiologist's conclusion. Reports describe; images let a clinician measure and compare.
Ask your imaging provider what is available: the image files themselves, the report, and whether the study can be repeated or transferred digitally. If you have more than one scan, keep them in date order and note whether the tear appearance changed between studies. A single line such as '2023 ultrasound reported a partial tear; 2025 MRI reported a full-thickness tear' is more useful than a paragraph of interpretation.
Do not attempt to grade your own tear or decide whether it is repairable. Tear size, retraction, tendon quality and muscle changes are assessed by the treating clinician, often with more than one imaging method. Your job is to make sure the raw material is present and clearly dated.
Repairability and alternatives: the questions your file should let a clinician answer
Rotator cuff repair reattaches the torn tendon to bone, and rehabilitation protects the repair while movement and strength recover. That describes the procedure; it does not tell you whether it applies to your shoulder. Not every tear needs surgery, and not every tear is repairable. Those two statements are separate, and your file should allow both to be assessed.
A clinician reviewing your case will want to know whether non-operative care has been given a fair trial, whether the tendon and muscle remain suitable for repair, and what the alternatives are if repair is not feasible. Your therapy addendum feeds directly into the first question. Your imaging and examination findings feed the second. Your goals and daily demands feed the third.
This is why the addendum should not argue a case. If you write 'therapy failed, therefore I need surgery', you have made a conclusion the clinician must now unpick. If you write 'twelve sessions over ten weeks, completed, pain reduced from 7 to 4 but range of movement unchanged, symptoms returned within six weeks of stopping', the clinician can draw their own conclusion and ask you better follow-up questions.
A worked administrative example: labelling and sequencing the file
Consider a patient who had a shoulder injury, then a course of physiotherapy, then a steroid injection, and now has a recent MRI. The file could be assembled in four labelled parts. Part one: current question and main symptoms. Part two: original injury and diagnosis, with the earliest imaging. Part three: therapy addendum, covering physiotherapy and injection separately, each with dates, provider type, what was done, response and supporting documents. Part four: most recent imaging and any current examination findings.
The value of this structure is that each part answers one question. A reviewer can read part three alone and understand the treatment history. They can read part two and four together and compare structural findings over time. Nothing is repeated, and nothing important is hidden inside a narrative.
Two practical points. First, keep dates in one consistent format and use the calendar year, because date conventions differ between countries. Second, if a document is in another language, say so and state whether a translation exists. Do not translate clinical terms yourself if a professional translation is available; a mistranslated therapy term can change how the history reads.
What to confirm with the China provider, and your next step
You cannot assume how a particular hospital in China will receive, store or act on your records. Those are provider-specific administrative questions, and the honest approach is to ask them directly rather than rely on a general assumption. Ask what format they prefer for imaging, whether they want the therapy addendum as a separate document, and whether they need anything certified or translated before review.
Ask, too, what the review can and cannot establish. A records-based opinion can discuss the therapy history, the imaging findings and the range of options. It cannot confirm repairability, final suitability for surgery or hospital acceptance, because those depend on examination and on the treating team's own assessment. Ask what further information would be needed to move from review to a decision.
If you want help organising this, ChinaSpecialistCare can coordinate a specialist appointment or a records-based review, and the relevant procedure reference explains the operation itself. An initial enquiry is free and only needs a brief summary, not your complete archive. Start by sending the therapy addendum and your most recent imaging report, then ask what else the clinical team wants before they can give you a useful opinion.
Sources & scope of this guide
References and official service information relevant to this guide.
This is general planning information and has not been individually reviewed by a doctor. Medical decisions and personal treatment advice come from your treating clinicians.