Rotator cuff surgery repairs torn tendons in the shoulder, a complex network of muscles and tendons vital for arm stability and movement. While surgery addresses physical damage, successful recovery extends beyond the operating room. Understanding the post-operative period is important for patients seeking to regain shoulder function and resume daily activities.
Immediate After Surgery
Upon waking from anesthesia, individuals experience pain in the surgical area, managed through various methods. A nerve block, administered during the procedure, can numb the arm for several hours, providing initial pain relief. As it wears off, oral pain medications, including non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and sometimes narcotics, are prescribed to control discomfort. Applying ice packs to the shoulder frequently for 10-20 minutes, with a cloth barrier, also helps reduce swelling and manage pain.
The arm is placed in a sling or immobilizer to protect the repaired tendons and allow them to heal. An abduction sling, which holds the arm slightly away from the body, may further reduce tension on the repair. Most patients wear the sling continuously for four to six weeks, even during sleep, removing it only for specific exercises or showering.
Wound care involves keeping incision sites clean and dry. For arthroscopic procedures, bandages may be removed within 24 to 72 hours, allowing gentle showering over incisions. Open surgery may require bandages to remain in place longer until cleared by the surgeon. Patients typically return home the same day or after a brief overnight stay, with instructions on supporting the arm, especially when sleeping, often in a recliner or with pillows to elevate the upper body.
The Rehabilitation Process
Rotator cuff rehabilitation is a phased approach, designed to gradually restore shoulder function while protecting the healing repair. The initial phase, known as passive motion, lasts for the first six weeks post-surgery. During this time, a physical therapist or specialized device moves the patient’s arm without active engagement from the rotator cuff muscles. This gentle movement helps prevent stiffness and promotes early healing without stressing the repaired tendons.
As healing progresses, usually between six to twelve weeks, patients transition into the active-assisted motion phase. In this stage, the patient begins to assist in moving their arm, working with the therapist or using assistive tools to increase range of motion. This phase builds upon passive movements, encouraging controlled muscular engagement without placing excessive strain on healing tissues. The gradual increase in movement helps re-educate the shoulder muscles and improve joint mobility.
The active motion and strengthening phase typically begins around twelve weeks post-surgery, though timelines can vary based on the tear’s size and the surgeon’s protocol. Patients actively move their arm independently, and resistance exercises are gradually introduced to rebuild muscle strength. These exercises are carefully progressed by the physical therapist, often starting with light resistance bands or bodyweight, and aim to restore full strength and control to the shoulder.
Physical therapy plays a central role throughout recovery, providing targeted exercises and techniques to improve flexibility, reduce pain, and enhance muscle strength and stability. Adherence to the prescribed exercise program, both in therapy sessions and at home, is important for optimal outcomes. Significant recovery, including regaining strength and range of motion, often spans six to nine months, with a gradual return to daily activities, light work, and eventually more strenuous tasks.
Navigating Recovery and Long-Term Outlook
Even after formal physical therapy concludes, ongoing aspects of recovery can present challenges, such as persistent stiffness or occasional discomfort in the shoulder. These issues can stem from scar tissue formation, residual inflammation, or the body’s natural healing response. Continued adherence to a home exercise program is important to maintain the gains made in therapy and to further improve shoulder function over time.
Patients should be aware of certain signs that might indicate a complication and warrant contacting their surgeon. These include unusual or increasing pain that is not relieved by medication, new or worsening swelling, warmth or redness around the incision, pus draining from the wound, or a fever. Persistent numbness or tingling in the fingers or hand should also be reported.
A realistic outlook on full recovery acknowledges that while most patients achieve good results, regaining complete pre-injury function can take a year or more. Some individuals may not achieve 100% of their previous strength or range of motion, particularly with larger tears or in older patients. There is also a risk of re-tearing the repaired tendon, especially if activities are resumed too quickly or if the initial tear was extensive.