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What to Expect After Rotator Cuff Repair Surgery

Your rotator cuff is a group of four muscles that act to stabilize your shoulder. Each of these muscles attaches to the head of your humerus (your upper arm bone) and work to both rotate and lift your arm. The tendons of these muscles are commonly torn either through a traumatic injury or due to repetitive stress across the tendon causing fraying. In some individuals, one of the tendons may tear completely, resulting in an inability to move your arm into a certain motion. The most common tear occurs in your supraspinatus tendon, the muscle responsible for lifting your arm however, tears may occur in any of the four tendons. Your rehabilitation restrictions will depend on the specific tendon that you tear, but also on any other procedures that may be done during the surgery. In combination with repairing your rotator cuff tendon, your surgeon may also perform a subacromial debridement, a labral repair, or debridement of another tendon such as your biceps tendon.

Phase 1: Protection/Passive Range of Motion Phase Since your surgeon is repairing active tissue (meaning muscle/tendons), the first phase typically involves no active range of motion. This means, you are not allowed to move your arm until the surgery has time to set. You will be placed in a sling which you will wear all the time in order to prevent you from moving your arm. Your sling may differ based on the type of tendon that was repaired during your surgery. Tissue healing is typically 6-8 weeks, so almost all surgeons will not allow you to move your arm until at least 6-8 weeks have passed since your surgery. Some surgeons will send you to PT right away and have your PT perform what is known as passive range of motion, meaning your PT will move your arm. You may also be allowed to perform passive movement of your arm, such as pendulums.

Phase 2: Active Range of Motion Phase This second phase typically begins around 6-8 weeks of healing. At this point, you will likely be discharged from the use of your sling and you will begin to use your arm. However, during this phase protection is still key. You are restricted from any lifting of objects during this phase, as this could cause the repair to rupture. The emphasis on this phase is returning your motion to full.

Phase 3: Strengthening This phase starts somewhere between 10-12 weeks of healing. During this phase you will begin to slowly strengthen your affected arm and continue to progress your range of motion if needed. At this time, you can expect that you will start to be able to use your arm for daily activities. At the beginning of this phase however, you are still restricted from lifting any heavy objects. As your PT progresses, your arm will get stronger, and you should expect improvement in strength during this phase. If you are an athlete that performs overhead activities, you may continue to have restrictions which may not be lifted until 24 weeks or longer. Your restrictions will be based on your individual surgeon and the specific surgery you had. Depending on your surgery, it may take upwards of a full year before you are back to high demand overhead activities such as throwing, serving, and swimming.

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