Table of ContentsView AllTable of ContentsWhat Is Rotator Cuff Repair Surgery?4 Stages of Post-Operative Physical Therapy
Table of ContentsView All
View All
Table of Contents
What Is Rotator Cuff Repair Surgery?
4 Stages of Post-Operative Physical Therapy
Therotator cuffis a grouping of four shoulder muscles (thesupraspinatus, the teres minor, theinfraspinatus, and thesubscapularis). This muscular group surrounds the head ofthe humerus(the ball-shaped top of the arm bone) and helps to elevate and rotate your shoulder.
These muscles are also responsible for adding stability to the joint and ensuring that the humeral head stays centered in the socket (glenoid) portion of the joint.
Occasionally, one (or more) of your rotator cuff muscles can eitherpartiallyor completely tear. This can happen as a result of wear and tear over time or after a traumatic injury.
Regardless, this issue can significantly impact the strength, stability, and movement of your arm. Because of this,a rotator cuff repair surgerymay need to be performed.
This article will review this procedure and the physical therapy needed after the surgery to aid recovery, regain strength, and restore the full range of motion in your shoulder.
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Not every rotator cuff tear needs to be repaired. In fact, asymptomatic rotator cuff tears are common. Multiple studies have found that the prevalence of asymptomatic rotator cuff injuries may be as high as 46%.
That said, there are certain specific symptoms and situations where a rotator cuff repair surgery may be warranted. These include:
The rotator cuff repair procedure may be done using a larger shoulder incision (called an open repair) or a slightly smaller incision (called a mini-open repair). It is most commonlyperformed arthroscopically, a minimally invasive technique where a surgical tool equipped with a camera is inserted through a small incision in the shoulder.
Physical therapy (PT)is also typically initiated early on after surgery to help jump-start your recovery. While in PT, your rehab is commonly divided into several distinct phases:
Passive Range of Motion
Early on after surgery, the main goal of therapy is to slowly advance your shoulder’srange of motionwhile protecting the surgical repair. Actively moving the arm is not allowed, so your therapist will gently stretch the shoulder passively to reduce the stiffness in the joint.
Your therapist will also provide instruction on how to perform daily tasks like bathing or dressing without activating the affected muscles.
Soft tissue massage and icing may also be utilized to alleviate the post-operative soreness and swelling that normally occurs. There is still some disagreement about the optimal duration of this rehab phase.
That said, this stage of therapy typically lasts for two to eight weeks, depending on the size of the tear and your surgeon’s preferences.
Active-Assisted and Active Range of Motion
During the second phase of rehab, your PT will clear you to begin stretching your shoulder on your own with the assist of your other arm or another object (like a cane or pulleys). You will also be cleared to discontinue the use of your sling and to startactively movingthe arm as much as you can tolerate.
Initial Strengthening
In the next portion of rehab, your therapist will begin instructing you on exercises that start to gently strengthen your rotator cuff muscles. By this point, the surgical repair is more secure and can tolerate light resistance.
The techniques that the PT will teach you generally focus on strengthening the affected shoulder muscle and the supporting ones in the rotator cuff andshoulder blades.
The duration of this phase can vary widely depending on the extent of the surgery and your pre-existing strength, but generally, it lasts between two and three months.
Late Strengthening
If a return to athletics is desired,sport-specific exercises for throwingmay also be introduced during this stage. The timeline for this portion of PT is variable, but it can take several months before you are fully discharged from therapy.
Summary
Rotator cuff repair surgery involves fixing torn or damaged tendons in the shoulder. This surgery typically requires four stages of physical therapy as you recover. In the first two to eight weeks after surgery, you’ll limit movement, wear a sling, and work with a PT on passive stretching. In the second stage, you’ll work on active stretching. Finally, you’ll work on initial strengthening and eventually weight-bearing strengthening until you get back to normal levels of movement.
A Word From Verywell
Recovering from a rotator cuff repair requires both persistence and patience. While most people eventually see improvements in their pain, range of motion, and function, these benefits can take time.
To maximize the likelihood of successful rehabilitation, be sure to find a physical therapist who is skilled in treating patients who undergo rotator cuff repairs. Working hand in hand with a knowledgeable PT gives you the best chance at a successful outcome.
5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Orthopaedic Surgeons.Rotator cuff tears.Lawrence RL, Moutzouros V, Bey MJ.Asymptomatic rotator cuff tears.JBJS Rev. 2019;7(6):e9. doi:10.2106/JBJS.RVW.18.00149American Academy of Orthopaedic Surgeons.Rotator cuff tears: surgical treatment options.Thomson S, Jukes C, Lewis J.Rehabilitation following surgical repair of the rotator cuff: a systematic review.Physiotherapy. 2016;102(1):20-28. doi:10.1016/j.physio.2015.08.003Edwards PK, Ebert JR, Littlewood C, Ackland T, Wang A.A systematic review of electromyography studies in normal shoulders to inform postoperative rehabilitation following rotator cuff repair.J Orthop Sports Phys Ther. 2017;47(12):931-944. doi:10.2519/jospt.2017.7271
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Orthopaedic Surgeons.Rotator cuff tears.Lawrence RL, Moutzouros V, Bey MJ.Asymptomatic rotator cuff tears.JBJS Rev. 2019;7(6):e9. doi:10.2106/JBJS.RVW.18.00149American Academy of Orthopaedic Surgeons.Rotator cuff tears: surgical treatment options.Thomson S, Jukes C, Lewis J.Rehabilitation following surgical repair of the rotator cuff: a systematic review.Physiotherapy. 2016;102(1):20-28. doi:10.1016/j.physio.2015.08.003Edwards PK, Ebert JR, Littlewood C, Ackland T, Wang A.A systematic review of electromyography studies in normal shoulders to inform postoperative rehabilitation following rotator cuff repair.J Orthop Sports Phys Ther. 2017;47(12):931-944. doi:10.2519/jospt.2017.7271
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Academy of Orthopaedic Surgeons.Rotator cuff tears.Lawrence RL, Moutzouros V, Bey MJ.Asymptomatic rotator cuff tears.JBJS Rev. 2019;7(6):e9. doi:10.2106/JBJS.RVW.18.00149American Academy of Orthopaedic Surgeons.Rotator cuff tears: surgical treatment options.Thomson S, Jukes C, Lewis J.Rehabilitation following surgical repair of the rotator cuff: a systematic review.Physiotherapy. 2016;102(1):20-28. doi:10.1016/j.physio.2015.08.003Edwards PK, Ebert JR, Littlewood C, Ackland T, Wang A.A systematic review of electromyography studies in normal shoulders to inform postoperative rehabilitation following rotator cuff repair.J Orthop Sports Phys Ther. 2017;47(12):931-944. doi:10.2519/jospt.2017.7271
American Academy of Orthopaedic Surgeons.Rotator cuff tears.
Lawrence RL, Moutzouros V, Bey MJ.Asymptomatic rotator cuff tears.JBJS Rev. 2019;7(6):e9. doi:10.2106/JBJS.RVW.18.00149
American Academy of Orthopaedic Surgeons.Rotator cuff tears: surgical treatment options.
Thomson S, Jukes C, Lewis J.Rehabilitation following surgical repair of the rotator cuff: a systematic review.Physiotherapy. 2016;102(1):20-28. doi:10.1016/j.physio.2015.08.003
Edwards PK, Ebert JR, Littlewood C, Ackland T, Wang A.A systematic review of electromyography studies in normal shoulders to inform postoperative rehabilitation following rotator cuff repair.J Orthop Sports Phys Ther. 2017;47(12):931-944. doi:10.2519/jospt.2017.7271
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