Rehabilitation Services Blog

July 22, 2019

What To Expect After A Rotator Cuff Surgery?

Rotator cuff surgery is a common procedure that is performed to address a partial or complete tear of your rotator cuff tendons. The four rotator cuff tendons and their associated muscles are responsible for moving your arm. They work together with other muscles that attach to your shoulder blade to allow you full range of motion of your shoulder.

Pain Control 

Pain will be managed throughout your rehabilitation by both your surgeon and your physical therapist. In general, it is recommended to ice your shoulder for 20 minutes, 3-4 times per day starting the day of surgery and continue as needed throughout the entirety of care.

Post-Operative Sling

Your shoulder will be protected in a sling to support your surgically repaired  arm for 4-6 weeks, depending on your surgeon’s recommendation. The sling will support your operative arm while reminding you not to use your upper extremity during the tendon healing process. The sling should be positioned in such a way that your elbow is bent to 90 degrees so that your hand is at or above your elbow. During this time, you can move your wrist, hand, and fingers without restrictions. Depending on your surgical procedure, your elbow may also be allowed to have active movement. The sling should be worn at all times unless advised otherwise by your surgeon or when performing your therapeutic exercises, icing, performing incision site dressing changes, and showering. 

Showering/Self Care Post-Operatively

Typically, you may shower two days after surgery. However, the incisions should be protected from getting wet. Washing under your arm can be performed while leaning over with your surgical arm in a dependent, hanging position.

Sleeping at Night 

Sleeping may become difficult due to pain and an inability to sleep on the surgical side. Most patients are required to wear the sling at night for the first 6 weeks. However, many patients are more comfortable sleeping in a recliner or a semi-reclined position in bed. Pillows can be used to prop yourself and/or your arm (in the sling) up in bed if a recliner is not an option. It is most helpful to keep your arm in a position where you can always see your elbow. 

 

General Precautions for at least the first 6-12 weeks (Follow surgeon’s instructions)

  • No reaching behind your back (no excessive shoulder extension) 
  • Do not use your arm to push up/off your bed or chair
  • Keep your arm close to your body
 

Physical Therapy 

Outpatient physical therapy begins within the first six weeks and typically manages your recovery 2-3 times per week, for 12-16 weeks post-operatively. During this time, a physical therapist will progress exercises and stretches according to the surgeon’s protocol and phase of recovery. Your physical therapist will also use techniques such as soft tissue and joint mobilizations to make sure full range of motion and proper joint mechanics are achieved. 
 

During weeks one through six, your physical therapist will initiate passive range of motion exercises and perform passive manual stretching of your surgical arm. If exercises are done correctly there should be no muscle activation of your rotator cuff muscles in order to protect the tendon repair. Your physical therapist will also assist with reducing inflammation and pain through therapeutic modalities such as ice and electrical stimulation. 
 

During weeks six through twelve, active assisted and active range of motion may be initiated. Examples of exercises that may be provided include using a pulley system and dowel to assist with regaining full range of motion. During this time, the tissues continue to heal and it is important to remember that even though you may begin using your surgical arm for activities of daily living you should not be lifting anything heavier than approximately 2-5 pounds. 
 

At twelve weeks, physical therapy will focus on strengthening exercises.  Your physical therapist will progress your strengthening as appropriate. Examples of exercises may include progressions of scapular stabilizing, strengthening and using resistance bands. The focus of treatment is on addressing all motions the shoulder naturally performs, while emphasizing stability of your shoulder blade. Return to prior activities such as throwing a ball or playing golf can take up to six months. 
 

Remember that every recovery is individual and these are general guidelines. If you have any questions throughout your recovery please refer back to your surgeon or physical therapist. 

Exercise Video Demonstrations

Pendulum



Scapular Retraction



External Rotation - Rotator Cuff



Internal Rotation - Rotator Cuff



 

     

Citations:

https://www.brighamandwomens.org/assets/BWH/patients-and-families/rehabilitation-services/pdfs/shoulder-arthroscopic-rct-repair-protocol-hybrid-patient-therapist.pdf


Catherine Sandoval, PT, DPT








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