Shoulder injuries can be painful and limiting. If you have a torn rotator cuff, surgery could help restore mobility and relieve pain. The sports medicine specialists at NCSH can talk to you about rotator cuff tear surgery, whether it’s right for you, and what to expect for recovery.

About Rotator Cuff Tears

The rotator cuff is a group of four muscles with tendons that attach them to the bones that make up the shoulder joint. This group of muscles and connective tissues keeps your arm in your shoulder socket. It attaches the humerus (upper arm bone) to the scapula (shoulder blade). It allows you to rotate and lift your arm.

A rotator cuff tear occurs when one or more of the tendons tear. Tears can be partial or complete, meaning the tendon completely tears away from the bone. Most tears occur in the supraspinatus tendon and are complete.

There are two leading causes of rotator cuff tears:

1. Acute. An acute tear results from a sudden injury that tears the tendon. Examples include using a jerking motion to lift a heavy object or falling on your outstretched arm. Acute rotator cuff tears are often associated with other injuries, like bone fractures or shoulder dislocation.
2. Degenerative. Degenerative rotator cuff tears result from wear and tear over time. Repetitive motion can cause this injury. Older adults are at greater risk for degenerative tears due to reduced blood supply to the tendons.

Can a Rotator Cuff Tear Heal Without Surgery?

Rotator cuff tears do not heal without surgery, but this doesn’t mean surgery is always needed. Nonsurgical treatments can be enough to relieve pain and improve mobility in the joint. The risk of not having surgery is that the tear can become worse. Eventually surgery is usually needed.

A shoulder surgeon can evaluate your injury and determine if surgery is the right option. In general, good candidates for surgery have symptoms for six months or longer, have large tears, and have poor shoulder function. Surgery is also more common in acute injuries.

What Happens During Rotator Cuff Tear Surgery?

The type of procedure your surgeon uses depends on individual factors. They can explain which repair type they have chosen, why, and what will happen during surgery.

• Open Repair. This is a traditional type of procedure that uses a large incision. The surgeon also uses an incision in the shoulder muscle to get access to the injured tendon and to repair it. Open repair is typically used for large or complicated tears.
• Arthroscopic Repair. In an arthroscopic procedure, the surgeon makes a small incision and inserts a camera to view the injury and guide surgical instruments. This is minimally invasive and usually an outpatient procedure.
• Mini-Open Repair. This type of procedure involves a smaller incision than in an open repair. The surgeon uses arthroscopic equipment to remove bone spurs or damaged tissue. They then repair the rotator cuff using traditional methods.

Regardless of the procedure type, surgeons repair torn rotator cuff tendons using sutures or suture anchors to reattach them to the bone.

Typical Recovery Milestones for Rotator Cuff Surgery

Each individual patient’s rotator cuff surgery recovery time is different, but there are some standard milestones most people experience. A full recovery can take 4 to 6 months. For the first couple of weeks, you’ll focus on keeping the shoulder immobile, watching for any signs of complications, and managing pain.

What To Expect 2 Weeks After Rotator Cuff Surgery

At this point, most patients will have their sutures removed and can shower again. However, it’s still important to be careful with the wound and avoid scrubbing it. You might consider sleeping semi-upright during this early phase.

What To Expect 1 Month After Rotator Cuff Surgery

By one month or six weeks, you will probably be able to remove the sling you’ve been wearing to immobilize your shoulder. You’ll be working on physical therapy but still doing passive exercises, meaning the therapist will move your arm for you.

What To Expect 3 Months After Rotator Cuff Surgery

Three months into recovery, you should be doing more active therapy exercises and moving your shoulder on your own. The goal of this part of recovery is to build strength in the joint’s muscles and tendons.

Don’t expect to be back to full strength or many normal activities until at least six months after your procedure. Trying to do too much can reinjure the joint. Follow your surgeon’s and therapist’s guidelines carefully until you are cleared to perform all normal activities.

Complications After Rotator Cuff Surgery

Complications are not common, but you should be aware of them. If you have any troubling symptoms or signs, talk to your surgeon right away. A surgical wound infection or a deeper infection are serious concerns.

Superficial infection causes redness, pain, warmth, and swelling at the surgical site. If not managed, this can lead to sepsis, a very serious and life-threatening infection. Signs of sepsis include severe pain, fever, shortness of breath, a high heart rate, clamminess, and confusion. These signs should be considered an emergency.

Other potential complications of surgery include nerve injuries, stiffness in the joint, blood clots, and re-tears in the tendon. Your surgeon will give you a list of symptoms and signs to watch for. Contact them if you experience any.

If you’re experiencing shoulder pain that doesn’t get better with rest, you might have a rotator cuff tear. Schedule an appointment to see one of our specialists for an evaluation and to discuss treatment options.

FAQs

What Can I Do and Not Do After Rotator Cuff Surgery?

Your surgeon will explain your restrictions post-surgery. Immediately after surgery, you will need to keep your shoulder immobilized so you cannot lift anything or drive. You also must avoid getting the surgical incision wet.

How Can I Manage Pain After Rotator Cuff Surgery?

Your surgeon will discuss pain management with you. They will recommend or prescribe medications to help you deal with the pain that is common right after a procedure.

Will I Need Physical Therapy After Rotator Cuff Surgery?

Yes, all patients benefit from physical therapy after surgery. You will start soon after your procedure to aid the healing process. Your therapist will do exercises with you and prescribe exercises for you to do at home. Follow their instructions, and don’t try to do too much too quickly.

Is Tendinopathy Common After Rotator Cuff Surgery?

Tendinopathy is inflammation, swelling, and pain in the joint’s tendons. You will likely experience symptoms like these immediately after surgery, but they should improve with time.