Recovering From Rotator Cuff Repair Surgery

man gripping shoulder in pain outdoors

Rotator cuff repair is a commonly performed shoulder surgery for torn rotator cuff tendons. The tendon tear can happen in acute injuries such as falling onto outstretched hands, in contact sports, or it may happen gradually over time in the elderly population.

Not all tendon tear needs to be repaired. The body has powerful self-healing process. Even if the torn tendon does not grow back, other muscles around the shoulder can compensate and the shoulder will still be able to function normally.

Therefore, it is suggested that patients with rotator cuff tendon tear should undergo at least 6 weeks of conservative management before deciding on operation.

Surgery is not magic that restores the normal pain free movement of the shoulder in no time. In fact, the road to recovery after the operation is a painstaking process lasting for several months. It is important for patients and families to understand the amount of time and effort that needs to be dedicated to the rehabilitation process before saying yes to the operation.

How will it feel immediately after the operation?

The shoulder will be in a literal quarantine after the operation for around 6 weeks. An arm sling needs to be worn 24 hours a day to reduce the movement of the arm. This is to minimize the contraction of the muscles that were just operated on. Six weeks is the time that is required for the tendons to heal adequately to sustain muscle contraction again.

Some pain and swelling should be expected around the wound. Medications will be prescribed for pain control. As long as the arm is kept in the arm sling, pain should be minimal. Sleeping, however, could be disturbed as the operated shoulder stops the patients from turning to that side. Lying on the affected side may continue to be uncomfortable for several months.

The patients are allowed to take the arm sling off briefly for some simple exercises of the arm to minimize joint stiffness.

What will happen after 6 weeks?

From 6 weeks onwards it will be the golden time for post-op rehabilitation to regain normal shoulder movement and strength.

The shoulder joint will be very stiff after 6 weeks in the arm sling. This is because a lot of scar tissue has formed around the surgical area as part of body’s recovery process. Our normal body tissue around the shoulder is very flexible to allow big range of movement.

Scar tissue, however, is tougher than normal tissue, and thus will restrict shoulder movements. Therefore, one of the most important part of post-op rehabilitation is to massage and stretch the scar tissue to allow normal range of shoulder movement. This process is usually painful and require the patient to perform daily home exercises to achieve lasting improvement.

If shoulder pain physio rehabilitation is delayed, it will be more difficult to regain normal shoulder movement in later stage as the scar tissue hardens over time.

The time that is required to regain full range of shoulder movement varies between patients from 3 months to 6 months. It depends on many factors such as the extent of injury, extent of operation, and patient’s compliance to exercises.

As the range of movement improves, the next focus of rehabilitation would be regaining the strength of the shoulder muscles. All muscles surrounding the shoulder would have undergone significant deconditioning after months of reduced use. The patients may feel that it takes a lot of effort even to lift the arm. Daily activities such as pouring water and pushing a door could be very difficult in the beginning.

The strengthening, however, needs to start with very gentle contractions and progress very gradually. This is to protect the operation site from re-injury. At this stage, gentle strengthening helps to stimulate recovery, but excessive strengthening may lead to pain and hinder the rehabilitation. Once again, it is important for patients to follow therapist’s prescription of exercises and carry out the home programs with good discipline.

Can I go back to sports after the operation?

With the rehab protocol carefully followed, returning to sports is possible. Singapore physio sessions facilitate this process by providing tailor-made exercise programs according to each individual’s progress and goals. This usually takes around 6 months.

Hopefully, you are reading this before your surgery so that you are now more mentally prepared for the surgery. Setting your expectations so that the surgery and physiotherapy is as smooth as it can be.

If you are reading this after the surgery, it is still not too late to calibrate your goals. Speak to your physiotherapist and doctors to set timeline and goals. The rehabilitation journey is tough and you can do it!

Darek Lam

Senior Principal Physiotherapist

Shirley Le, writes in detail and this shows in her meticulous work with her patients. She constantly upgrades her clinical skills to be at the forefront of her physiotherapy practice.
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