Rotator Cuff Rehabilitation
Rotator Cuff Rehabilitation and Recovery
If you have suffered a rotator cuff injury or undergone surgical repair of a rotator cuff tear, rehabilitation will play a critical part in your recovery and return to pain-free shoulder function. A rehabilitation program for the rotator cuff is specially designed to protect the tendons during the recovery period but at the same time permit strengthening and range of motion exercises. These exercises should be performed under the careful supervision of an experienced physical therapist, at least in the immediate postsurgical and early recovery period.
In this article, we discuss what the rehabilitation and recovery process for rotator cuff injuries involves. We also talk about the types of exercises you’ll need to do and the precautions you must take if you have undergone rotator cuff surgery.
Why is Rehab Necessary After Rotator Cuff Injury or Surgery?
When the rotator cuff is injured or when the shoulder joint has been operated upon, the tissue becomes inflamed. This is a normal healing response of the body. There is increased fluid between the cells of the tissue, inflammatory cells, and a growing number of blood vessels. The body responds to the inflammatory reaction by laying down collagen tissue to heal the injury. If the shoulder is not mobilized during the recovery period, the collagen gets laid down in a disorganized manner, resulting in scar tissue formation. This can lead to complications like adhesive capsulitis (frozen shoulder), in which the joint becomes tight.
When you perform gentle stretching and strengthening exercises during rotator cuff rehabilitation and recovery, the reparative collagen is laid down in an organized fashion along the normal lines of stress, building strong tendons. Therefore, gently exercise below the limits of pain, being sure to follow the limitations put in place by your surgeon and icing the shoulder or using anti-inflammatory medications during rehabilitation can speed up your recovery and help restore a strong shoulder joint.
Pain Management for Rotator Cuff Injury or Post-Surgery
Shoulder pain is the main symptom of a rotator cuff injury. It is also expected that you will feel pain after a rotator cuff surgery. Your doctor will prescribe pain medications to help you recover from surgery and keep you comfortable while the rotator cuff heals. It is worth remembering that pain medications are for the short-term management of pain.
Your doctor may prescribe oral medications, including NSAIDs (non-steroidal anti-inflammatory medications) like ibuprofen, prescription opioid pain pills, local anesthetics, or a combination of these therapies to keep your pain under control. You should be aware that NSAIDs and other pain medications can cause serious side effects.
Moreover, opioids carry a risk of dependency and can be highly addictive. That’s why these medications should be used with caution, always under a doctor’s supervision. You should stop taking pain medications as soon as your pain begins to improve.
Rotator cuff rehabilitation exercises
Rehab exercises play a critical role in getting you back to pain-free shoulder function. In the immediate postoperative period, you may be asked to keep your arm immobile to give the tendon repair time to heal. The duration of this initial period of immobilization is usually 4-6 weeks but will depend on the severity of your rotator cuff injury. You should follow your surgeon’s instructions about protecting your shoulder during this time.
Once your surgeon gives you the green light, you can start working with a physical therapist who will perform passive range of motion exercises for your shoulder and arm. During these passive exercises, the therapist will support the joint and move your arm into different directions to put the shoulder through its normal range of motion. This is important to prevent the formation of adhesions that can result in stiffness and pain.
After approximately 4-6 weeks of passive range of motion exercises for the shoulder, you can progress to active exercises. These exercises will help increase muscle strength and flexibility.
Approximately 8-12 weeks after your rotator cuff surgery, you can start on a shoulder strengthening program. Complete recovery after injury or rotator cuff surgery can take 4-6 months sometimes even up to a year. It is a slow process, but if you are committed to your rehab program, you will see steady progress.
Rotator Cuff Exercises
In this video, Dr. Orcutt explains some easy concepts to understand as you work toward a stronger rotator cuff.
Check out our YouTube Channel for more information on Rotator Cuffs
Precautions During Recovery from Rotator Cuff Surgery
The exact postsurgical protocol will be given to you by your surgeon, based on the extent of your injury and the type of rotator cuff surgery you have undergone. You will progress through the various stages of rehabilitation, depending on your clinical presentation. The following precautions are generally advised to patients after rotator cuff surgery (again, you should follow your surgeon’s instructions).
After the rotator cuff surgery, your shoulder will be placed in a sling to keep the joint immobilized to allow the tendon to heal. The sling is typically advised for 4-6 weeks, and you should wear it as directed by your surgeon. Advancements in these types of medical devices have been made as with My Body Protector. Our goal is to provide you with the highest quality products for your postoperative journey and ensure you have the best products to help you recover safer and faster.
Typically after surgery, you should not lift the operated arm actively for the first 4 weeks after rotator cuff surgery. This means you should avoid lifting, reaching, pushing, pulling, or reaching behind your back with the operated arm for the first 4-6 weeks. You also should not lift objects that weigh more than 5 pounds with the operated arm for the first 6 weeks.
Icing the shoulder several times a day for 15-20 minutes at a time can help control postoperative swelling and inflammation. The surgeon may also provide you with a special device called a cryocuff that can bring cooling water to your shoulder. If you notice any increased redness, drainage, swelling, or pain in the shoulder after rotator cuff surgery, inform your surgeon as soon as possible.
Tendons take longer to heal compared to many other types of tissues in the body, for example, the skin, which is highly vascularized (it has lots of blood vessels). This is the reason that rehabilitation and recovery from rotator cuff injury or rotator cuff surgery can be a lengthy process. If you had a large rotator cuff tear or you are an older individual, the recovery can take even longer. However, the majority of patients experience good pain relief and return to much improved function after surgical treatment of rotator cuff injuries. The important thing is to follow your surgeon’s instructions and comply with the rehab schedule.