Orthopedics Orthopedic Surgery Post-Operative Recovery Rehab After Rotator Cuff Surgery By Jonathan Cluett, MD twitter linkedin Jonathan Cluett, MD, is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams. Learn about our editorial process Jonathan Cluett, MD Medically reviewed by Medically reviewed by Erin Pereira, DPT, OCS on May 13, 2020 linkedin Erin Pereira, PT, DPT, is a board-certified clinical specialist in orthopedic physical therapy. Learn about our Medical Review Board Erin Pereira, DPT, OCS on May 13, 2020 Print Table of Contents View All Day of Surgery The First Days Sleeping Passive Motion Active Motion Strengthening Full Activity Rotator cuff surgery is a common treatment for a torn rotator cuff. Most rotator cuff tears are treated without surgery, but there may be situations where surgery is the best treatment. In some cases, surgery is considered immediately after an injury, while in other situations, surgery is only the last step when all other treatments have failed. The surgical procedure to repair a torn rotator cuff is sometimes the easiest and most straightforward aspect of treatment, while rehab and recovery are the most challenging. Tetra Images / Getty Images People having rotator cuff surgery should understand each step of rehab as a good outcome is highly dependent on the healing and rehabilitation that follows surgery. Here is a timeline of the major steps following rotator cuff surgery. Day of Surgery Rotator cuff surgery is an outpatient procedure. Overnight stays in the hospital are generally unnecessary. The surgical procedure usually takes a few hours, depending on the extent of work needed to repair the torn tendons. After surgery, your arm will be placed into a sling. A sling that holds the arm slightly away from the side (an abduction sling) is generally recommended for rotator cuff repair surgery, as these hold the tendons in a more relaxed position. You will remain at the hospital until your pain is adequately controlled. Surgical Options for Rotator Cuff Repair The First Days The first days after rotator cuff surgery are focused on ensuring that your pain control is adequate. Your doctor will prescribe medications to help with discomfort. Trying different types of medication can be helpful; many doctors recommend alternating prescribed narcotic medications with anti-inflammatory medication. And don't forget about icing the shoulder. Ice application may be the most important part of pain control. Always try to prevent the pain from becoming severe by taking smaller doses of pain medication at the early signs of discomfort, rather than large doses when the pain is more severe. Sleeping at Night Sleeping after shoulder surgery can be a challenge. Even a moderate ache in the shoulder can prevent a good night's sleep. Many people find it most comfortable to sleep in a semi-upright position after rotator cuff surgery; a recliner is perfect. If you don't have a recliner, just get a lot of pillows and create a backrest in bed to allow you to sleep in a seated position with the elbow pointing down. A sleep-aid medication may be as helpful as a pain medication, as getting a good night's sleep can do as much for pain control as anything else. Recovery Phase 1: Passive Motion The first phase of recovery is passive motion only. This may last up to 6 weeks, depending on the size of the rotator cuff tear and the strength of the repair. Passive motion means the rotator cuff muscles and tendons are not doing any work. When the rotator cuff muscles contract, tension is placed on the repair that was performed. Passive motion means that the shoulder moves without placing tension on the repair. In order to perform passive motion, your therapist will move your shoulder for you. The therapist can also instruct you on how to move your own shoulder without contracting the rotator cuff muscles. Recovery Phase 2: Active Motion Active motion is initiated when there is sufficient healing of the tendons to allow them to start moving the arm, but before any extra resistance is applied. You may be limited to active motion for up to 12 weeks from the time of surgery. Active motion means that you can move your own arm, but not against resistance. 4 Exercises to Improve Shoulder Range of Motion Recovery Phase 3: Strengthening The strengthening phase of recovery is the most important. Because of the injury, surgery, and early phases of recovery, the muscles of the rotator cuff have become weak. Once the repair has adequately healed, it is important to begin strengthening the muscles to allow you to resume your normal activity level. The rotator cuff muscles do not need heavy weights for effective strengthening. A skilled therapist can instruct you on techniques to isolate the proper muscles for strengthening such that only light resistance bands or weights can provide an excellent workout. Rotator Cuff Strengthening Exercises Recovery Phase 4: Full Activity Full recovery after rotator cuff surgery often takes 4 to 6 months and in some cases longer. The critical factors that determine the length of the recovery are the size of the rotator cuff tear, the ability to adequately repair the tendons, and the commitment to rehabilitation. Knowing when to progress from one phase of rehab to the next is an art. Not all people will progress through rehab in the same way, and each individual must adhere to their prescribed rehab protocol. Discuss any specific questions you have about your rehab with your surgeon. A Word From Verywell This is a broad outline of the stages of rehabilitation that follow rotator cuff surgery. Keep in mind, that every patient, every tear, and every surgery are a little different. While having these steps is a helpful guideline, each patient needs to discuss their particular progress with their surgeon. Your progress may be faster or slower depending on a number of factors. While it is tempting to compare progress with friends, family members, or new acquaintances from the therapy office, their recovery may not be the same as yours. Make sure you know where you might need a little extra protection or extra time to get your shoulder back to peak condition. Was this page helpful? Thanks for your feedback! Dealing with joint pain can cause major disruptions to your day. Sign up and learn how to better take care of your body. Click below and just hit send! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. American Academy of Orthopaedic Surgeons. Rotator Cuff Tears: Surgical Treatment Options. Updated March 2017. American Academy of Orthopaedic Surgeons. Rotator Cuff and Shoulder Conditioning Program. Updated October 2012. Abtahi AM, Granger EK, Tashjian RZ. Factors affecting healing after arthroscopic rotator cuff repair. World J Orthop. 2015;6(2):211–220. doi:10.5312/wjo.v6.i2.211