Overview of Rotator Cuff Tear Repair Surgery
The rotator cuff is a common source of pain in the shoulder. It refers to a group of four muscles and tendons that attach to the head of the humerus and stabilizes the shoulder as it moves in space. The most commonly affected tendon is the supraspinatus tendon. Issues with the rotator cuff commonly cause problems with overhead activity, pain with sleeping on the shoulder, and moving the shoulder in certain motions. If torn, the rotator cuff can cause progressive pain and disability in the shoulder. Unfortunately, the rotator cuff has poor healing potential on its own and often requires surgical repair in many cases.
Individualized Rotator Cuff Tear Repair Surgery
Because complete rotator cuff tears do not heal by themselves and can cause progressive pain, surgery is sometimes required if the pain persists despite conservative measures. The surgery repairs the torn muscle tendon, and also removes the bone spur which can exacerbate the tear. In addition other structures that can cause shoulder pain are evaluated and addressed at the time of surgery depending on each individuals unique presentation and findings at surgery.
Relieving pain and restoring function to your shoulder is the goal of surgical repair. As every tear is different, different techniques are used to optimize the repair at surgery. The exact post-operative course depends on the quality of your tissue at surgery, size of the tear, and individual demands that will be placed on the shoulder post-op. You will probably be required to use a sling for around six weeks after surgery. This is for comfort and to help protect the muscles from unnecessary or damaging movement.
You may not have significant pain relief or an increase in motion for several months following rotator cuff surgery. The healing process, coupled with physical therapy, takes an extended period of time and is to be expected after rotator cuff surgery.
Physical therapy is a key component to any shoulder operation and essential to the success of rotator cuff surgery. You will be provided with a specific protocol for therapy that outlines the expected time course and limitations with activity.
What to expect after rotator cuff tear surgery?
Your first clinic appointment will be approximately 7 to 14 days after surgery. At this time, the sutures if present will be removed from your shoulder. Prior to your first appointment, please keep the incision clean and dry and do not get your incision wet. Once your stitches have been removed, you may shower normally. Ice or a cooling device is helpful in the immediate post-op period for pain control and this can be applied every 2 hours for 30 minutes at a time as necessary.
Take pain medication, if necessary, 1/2 hour before you exercise or do therapy. Once the stitches have been removed, a hot shower is also helpful, prior to exercise. This aids in relaxation and helps to decrease pain. Driving is generally not recommended after rotator cuff surgery until better control of the arm is achieved. Taking narcotic pain meds are not recommended while driving.
Importance of Physical Therapy after shoulder surgery
Physical therapy is critical to the success of shoulder operations. Just as important as adequate effort at the session with the therapist is continuing the therapy at home to get consistent improvements and gains.
Shoulder motion and pain are closely related, thus, as motion improves from exercising, the pain will diminish. Continued discomfort for four to six weeks after the operation is expected. Discomfort during exercises and therapy is normal; however, any drastic increases in pain or diminished functionality of the shoulder should be reported to our office.
Active motion of the shoulder, (i.e. active elevation in the front or lifting the arm to the side) before the shoulder has had time to heal will damage the repair and can be very painful. Please adhere to the protocol and post-operative instruction provided by your doctor before advancing your activities. Your exercises and therapy will be divided into phases based on the quality of the tissue and the type of repair. Do not progress or go on to the following phase of therapy unless instructed by your doctor. Advancing your protocol too rapidly may harm your shoulder.
In most cases, passive stretching exercises are done for the first several weeks after surgery. Strengthening exercises usually begin 4 to 12 weeks after your surgery, as instructed by your surgeon. This gives adequate time for the muscles to heal to the bone before placing large stresses on the repair.
Morning stiffness is very common and you will probably feel more stiff in the morning and have more difficulty with exercises in the morning. This is normal and will go away with time and as your motion improves.
Final Thoughts on Rotator Cuff Tear Repair Surgery
Rotator cuff surgery is not to be undertaken lightly; however, if performed for the right reasons it can result in significant pain relief and an increased quality of life. If you have any further questions please don’t hesitate to schedule an appointment with Dr. Mazoch.