Rotator cuff surgery repairs torn tendons in the shoulder, aiming to restore stability, motion, and strength. This procedure addresses injuries that cause pain and limit arm function, often resulting from trauma, overuse, or age-related degeneration. Following the surgical repair, a structured physical therapy program becomes an integral part of the recovery process. This guided rehabilitation helps patients regain shoulder function and return to their daily activities.
General Timeline for Physical Therapy
Physical therapy typically begins within the first few weeks after rotator cuff surgery. Many patients start their initial session around seven to ten days post-operation. This early start focuses on protecting the surgical repair while gently initiating movement. The goal is to prevent stiffness and promote healing of the reattached tendon.
During the immediate post-operative period, the arm is usually immobilized in a sling for several weeks, often three to four weeks, to allow the tendon to heal to the bone. Even with immobilization, carefully guided passive movements are often introduced to maintain some range of motion without stressing the healing tissues. The entire physical therapy program usually lasts for three to four months, but complete recovery can extend up to six to twelve months for larger tears.
Factors Affecting PT Start Time
Several factors influence the precise timing of physical therapy after rotator cuff surgery. The type and severity of the rotator cuff tear play a significant role. Smaller tears may allow for earlier, more aggressive rehabilitation, while larger or massive tears often require a more conservative initial approach to protect the extensive repair.
The specific surgical technique employed, such as arthroscopic versus open repair, can also impact the surgeon’s post-operative protocol. A surgeon’s individual preferences and established protocols determine when it is safe to begin moving the shoulder without compromising the repair. Patient-specific factors, including age, overall health, and co-existing medical conditions like diabetes, can influence healing rates and the physical therapy timeline. Any post-operative complications, such as infection or excessive swelling, would also necessitate adjustments to the rehabilitation schedule.
What to Expect in Early Rehabilitation
The initial phase of physical therapy after rotator cuff surgery focuses on protecting the healing tendon while gradually restoring movement. During the first four to six weeks, the emphasis is on passive range of motion exercises. This means the physical therapist, or the patient using their other arm, moves the surgical arm without activating the repaired muscles.
Common exercises in this early stage include pendulum swings, where the patient leans forward and allows the arm to dangle and swing gently in circles, and passive forward elevation, using a stick or the unaffected arm to lift the surgical arm. These movements help to prevent stiffness and gently encourage the shoulder’s natural range of motion without putting stress on the delicate repair. The patient typically wears a sling during this period, removing it only for exercises or personal hygiene.
Why Following Your PT Plan is Crucial
Adhering to the prescribed physical therapy regimen and surgeon’s instructions is important for a successful recovery after rotator cuff surgery. The repaired tendons need adequate time and a controlled environment to reattach and heal to the bone, which can take six to eight weeks. Deviating from the plan, such as attempting active movements too early or lifting heavy objects, can place undue stress on the fragile repair.
Ignoring the therapy guidelines increases the risk of re-tearing the repaired tendon, which would necessitate further intervention and prolong recovery. Insufficient or inconsistent participation in physical therapy can also lead to shoulder stiffness, commonly known as “frozen shoulder,” where the joint loses its mobility. Consistent engagement in the rehabilitation program, including home exercises, is directly linked to regaining full range of motion and strength, ultimately facilitating a return to pre-injury activities.