Rotator cuff repairs are the second most common soft tissue surgery performed in the US, with almost 500,000 surgeries performed each year. Not all rotator cuff injuries require surgery, but for those that do, the rehab process can feel daunting.

Typically, you will start PT a few days after your rotator cuff repair. Some surgeons prefer to wait a few weeks before starting PT if there is a larger tear. Expect to be in a sling with a pillow for 4-6 weeks depending on the size of the tear you had.

At the first visit, our goals are to check your incision for signs of infection, change any bandages if necessary, and make sure you know how to get your sling on and off. We may also discuss ways to get dressed, shower, and take care of yourself one handed. Exercises may start with some gentle shoulder blade squeezes, neck motion, elbow motion, and passive shoulder ROM. Passive motion means you use an outside force (movement of your body, a table, etc.) to move the shoulder for you – you are not allowed to use your own muscles to move the shoulder until you’re out of the sling.

Often pain is higher in the first month after surgery and patients may have a harder time sleeping right after the surgery. Part of this is positioning of the shoulder and part of this is due to having to sleep with the sling on. Some patients find they are more comfortable in a recliner to start out.

Because a rotator cuff repair requires the surgeon to put stitches in the tendon, muscle, and bone, this is usually a slower recovery process than a joint replacement. For the first 4-6 weeks while you are in the sling, we want you working on passive range of motion of the shoulder. We will show you how to stretch and move the joint to protect the surgery in a way that still allows movement.

After you are out of the sling, we can start active assisted range of motion (using a cane or pulleys to help move the arm). Typically, we can start doing some strengthening of the shoulder muscles at around 6-8 weeks post operative. Keep in mind that since you haven’t been able to use those muscles in 2 months, we will start off very lightly and ease into strengthening. Muscle strengthening takes at least 12 weeks, so the total timeline of being in PT after a rotator cuff repair is often in the 4–6-month range depending on the person and their goals.

If you are hoping to get back to higher level sport activities (baseball, softball, throwing, swimming) we may keep you in PT closer to the 9-month mark or when you can fully return to your sport or activity. We typically see you twice per week until you have full range of motion, then can go down to once per week while working on strengthening. As we get closer to graduation from PT, we will typically space those visits out even further to every 2-3 weeks with focus on doing exercises at home.

If you have an upcoming shoulder surgery or shoulder pain, let us know how we can help you feel better!

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