Often times, post-surgical expectations regarding restrictions, precautions and guidelines are not given or were briefly reviewed prior to or post-surgery. The purpose of this blog post is to set appropriate expectations, which will help ease some of the fears associated with surgery and rehabilitation, as well as improve your understanding of what to expect after your rotator cuff repair surgery. If you are interested in reading our full protocol click HERE; this protocol serves as a guideline and is not intended to be utilized as a "one size fits all" template. If you haven’t had surgery and are wondering if surgery is right for you, we have written a blog on non-operative management of rotator cuff tears, click HERE.

Randelli (2012) literature review found the surgical operation to be very safe and is considered a low risk procedure. The most common post-operative complication they found is failure of the repair after surgery. Some research suggests up to a 50% failure rate of the rotator cuff repair after surgery. This might raise the question, WHY?

There are many contributors to why a rotator cuff repair can fail. This includes, but is not limited to, lower bone mineral density, older age, female, larger tear size, fatty infiltration, diabetes mellitus, and smoking. Other factors that can contribute to a failed repair include progressing shoulder movements too slow or too quickly, accelerated exercise prescription, and poor patient compliance of precautions and restrictions (such as not wearing your sling when recommended). The review of these prognostic factors, meaning predictability of outcomes, is not to increase fear nor anxiety, but to help improve your understanding of all the considerations that help us provide the best outcome possible. The above factors can fall into various categories, this includes non-modifiable and modifiable risk factors, as well as factors that are in your control and factors that are in your physical therapist’s control. Non-Modifiable Risk Factors - age, sex, tear size, fatty infiltration, type I diabetes

Modifiable Risk Factors - smoking

In Your Control - following recommended precautions and restrictions
Things for you to consider – You will be wearing your sling for roughly 6 weeks. On your first physical therapy visit you will learn what you can and cannot do, as well as how to modify dressing and other self-care activities. You will have a weight restriction up until 4 months. Expected return to prior level of function can take anywhere between 5-6 months depending on your activity level and goals.

In the Physical Therapist’s Control - range of motion progressions, exercise prescription and return to activity guidance.
Things to consider - Rotator cuff repair protocols should be based on the best available research as well as the Physical Therapist’s and Surgeon’s recommendations. If you are interested, here is a breakdown of our protocol, again, this serves as a guideline and not a template. Click HERE.

Below you will find a breakdown of our recommended guidelines for each tear size.

If you would like to talk to one of our licensed physical therapist, please click HERE, we offer FREE phone consults. We can answer any concerns or questions you may have. If you prefer to contact us directly, please click HERE for our clinic information.

Written by: Dakota Ezell, PT, DPT

Disclaimer: All information on this website is intended for instruction and informational purposes only. The authors are not responsible for any harm or injury that may result. Significant injury risk is possible if you do not follow due diligence and seek suitable professional advice about your injury. No guarantees of specific results are expressly made or implied on this website.

References
1) Randelli P, Spennacchio P, Ragone V, Arrigoni P, Casella A, Cabitza P. Complications associated with arthroscopic rotator cuff repair: a literature review. Musculoskelet Surg. 2012;96(1):9-16. doi:10.1007/s12306-011-0175-y