Rotator cuff surgery repairs torn tendons, anchoring them back to the bone. The initial two weeks following this procedure are the most restrictive period of recovery, focusing on protection and pain control to allow the tendon to begin healing. While recovery pathways vary based on tear size and surgical technique, general guidelines exist to manage the immediate post-operative experience.
Managing Pain and Initial Discomfort
The first few days involve significant discomfort as the local nerve block, administered during surgery, typically wears off between 24 and 72 hours post-operation. Patients manage pain using a prescribed regimen of oral medications, usually alternating between non-opioid and stronger narcotic medications for consistent coverage.
It is most effective to take pain medication on a scheduled basis rather than waiting for pain to become severe. This proactive approach keeps pain levels manageable, supporting better rest and compliance with permitted movements. Swelling and aching pain are common, so cold therapy, such as ice packs, should be applied for 20 to 30 minutes every hour or two to reduce inflammation. Report sudden, sharp, or uncontrolled pain immediately to the surgeon, as well as any signs of numbness or tingling in the hand.
Incision Care and Hygiene Protocol
Caring for the surgical incisions prevents infection and ensures proper wound healing. The initial surgical dressing must be kept clean and dry until the surgeon instructs otherwise, often for 48 to 72 hours. Once cleared to shower, the dressing is typically removed, but patients must avoid scrubbing the incisions or applying creams or ointments unless directed by the medical team.
The shoulder must not be submerged in water, meaning no baths, hot tubs, or swimming for at least six weeks. When showering, let water run gently over the incision and then pat the area completely dry. Signs of a potential complication require prompt medical attention, including increasing redness, excessive warmth, thick drainage, or an accompanying fever.
Daily Life Adjustments and Functional Restrictions
Protecting the repaired tendon requires the constant use of a shoulder sling or immobilizer during the first two weeks. This device must be worn full-time, including while sleeping, to prevent accidental movement of the shoulder joint. Sleeping comfortably is challenging, but many patients find relief by sleeping in a recliner or propped up with multiple pillows. This keeps the upper body elevated and the arm slightly away from the body.
Lifting, pushing, or pulling actions with the operative arm are strictly prohibited because these movements place excessive stress on the tendon. To dress, put the sleeve on the operative arm first, then the non-operative arm, reversing the process when undressing. Driving is not permitted while wearing the sling or taking narcotic pain medication, as reaction time and functional control are compromised. While the shoulder is immobilized, perform gentle exercises for the elbow, wrist, and hand, such as wrist circles, to promote circulation and prevent stiffness.
The Two-Week Milestone and Transition to Therapy
The two-week mark coincides with the first post-operative appointment with the surgeon or physician assistant. During this visit, the medical team assesses healing by examining the incisions, and any non-dissolvable sutures or staples are usually removed. This assessment confirms the wound is closed before the next phase of recovery begins.
This appointment is a transition point, often providing clearance to begin formal physical therapy (PT). Therapy in this initial phase is limited to passive range of motion (PROM) exercises. During PROM, the therapist or a machine moves the arm without the patient activating the shoulder muscles. This controlled movement prevents stiffness while protecting the surgical repair. Active movement, where the patient lifts the arm by contracting the muscles, remains restricted until later weeks.