Rotator cuff surgery repairs torn tendons in the shoulder, reattaching them to the humerus (upper arm bone). This procedure aims to restore function, reduce pain, and improve the shoulder’s strength, flexibility, and overall mobility when conservative treatments like physical therapy and medication have not provided sufficient relief. Understanding the process from preparation to long-term recovery helps set realistic expectations.
Preparing for Your Surgery
Before rotator cuff surgery, patients have pre-operative appointments for medical evaluations, including blood tests and electrocardiograms (EKG), to confirm overall health. Discussions with the surgical team and anesthesiologist address concerns and clarify the procedure and anesthesia plan.
Medication adjustments are necessary; patients receive instructions to stop blood thinners, ibuprofen, or aspirin about two weeks before surgery to minimize bleeding risks. Practical home preparations include arranging assistance, setting up a comfortable recovery area, and placing frequently used items at counter height to avoid straining the shoulder. Having loose-fitting clothing ready is also helpful.
The Surgical Day Experience
On the day of surgery, patients arrive at the hospital or surgical center one to two hours before their scheduled procedure. After check-in, the medical team prepares the patient, including placing an intravenous (IV) line, usually in the arm not undergoing surgery. The surgical team, including the surgeon and anesthesiologist, meets with the patient to answer final questions and confirm the procedure.
Anesthesia for rotator cuff repair involves general anesthesia, often combined with a regional nerve block. This block, an injection of local anesthetic near nerves in the neck or shoulder, numbs the arm and provides significant pain relief for several hours post-operation. Surgery is performed using an arthroscopic technique, where small incisions allow a camera and miniature instruments to repair the tendon on a monitor. For larger or more complex tears, a mini-open or open repair may be necessary, involving a slightly larger incision.
Immediate Post-Operative Period
Immediately after the procedure, patients wake up in a recovery area, feeling groggy from anesthesia and experiencing discomfort. Initial pain management strategies are implemented, including the ongoing effects of the nerve block, which can last for several hours. Oral pain medications, such as NSAIDs or narcotics, are prescribed as the block wears off. Applying ice packs to the surgical area is recommended to reduce swelling and pain.
The operated arm is placed in a sling to protect the repair and limit movement, often worn continuously for four to six weeks. This immobilizes the shoulder and supports the healing tendon. While most rotator cuff repairs are outpatient, some cases may require an overnight stay. Patients should expect limited use of the affected arm, with specific instructions on safe movements for the elbow, wrist, and hand.
Rehabilitation and Long-Term Recovery
Rehabilitation is a key part of recovery following rotator cuff surgery, guiding the shoulder through distinct healing phases. Physical therapy (PT) begins within days or a few weeks post-surgery, initially focusing on passive range of motion exercises where the therapist moves the arm. This passive phase helps maintain joint flexibility and reduce stiffness during the initial weeks.
As healing progresses, around six to twelve weeks after surgery, active-assistive exercises are introduced, allowing the patient to gently move the arm with some assistance, followed by active motion. Strengthening exercises, using light weights or resistance bands, begin after the initial healing period, around seven to eight weeks post-surgery. Adherence to the physical therapy regimen is essential to rebuild strength and restore full range of motion.
The timeline for full recovery varies, from four to six months for smaller tears, and up to six to twelve months for larger or more severe tears. Most patients gradually return to daily activities after about twelve weeks, though physically demanding jobs or vigorous sports may require four to six months or longer for complete resumption. This gradual process emphasizes protecting healing tissue and progressively increasing activity levels to prevent re-injury.
Factors Influencing Recovery and When to Seek Medical Attention
Several factors influence the speed and success of recovery after rotator cuff surgery. Patient-related elements like age, the initial size and severity of the tear, and tendon tissue quality significantly impact healing rates. Conditions such as diabetes, osteoporosis, and smoking can negatively affect tendon healing. Consistent adherence to the physical therapy program is also a key factor for a successful outcome.
While some pain and swelling are expected, certain signs warrant immediate medical attention. These include excessive bleeding, severe pain not managed by medication, or a sudden increase in swelling beyond the surgical site. Other concerning symptoms are fever above 101°F (38.3°C), signs of infection (redness, warmth, yellowish discharge), and numbness, tingling, or sudden loss of function in the hand or fingers. Contacting the surgeon or medical team promptly for any of these issues is important.