Rotator Cuff Surgery and Repair

July 10, 2008 by Rebecca Deal  
Filed under Physical Therapy

How long does it take a rotator cuff tendon to heal after a surgical repair?

A surgical rotator cuff repair requires a tendon reattachment into a bony anchor in the shoulder. The bone site of tendon reinsertion requires eight weeks to heal. Physical therapy, although specifics depend on the surgeon’s rehab protocol, usually begins three-five days after the surgery and continues for up to twelve weeks in three distinct phases until all prior shoulder function returns.

During phase one, the first eight weeks of physical therapy, while the bone is still healing, rehab is focused on symptom control and the return of symmetrical range of motion (ROM). Educating the patient to ice, encouraging the use of an arm support to rest the irritated tendons, and introducing the Codman pendulum exercises are all common strategies for controlling shoulder symptoms. ROM activities are limited in phase one to passive stretching (the patient must keep the muscles relaxed while the therapist stretches the rotator cuff muscles).

After the surgical repair site has healed and the patient has full ROM, emphasis shifts in phase two to shoulder strengthening. Strength work focuses on both rotator cuff muscles and the interscapular muscles to promote the return of normal shoulder biomechanics. Rotator cuff strengthening begins with isometric contractions and progresses to eventual strengthening with weight or Theraband resistance.

Phase three involves proprioceptive training for the upper extremity to ensure proper reaction time and future injury prevention. During week twelve of physical therapy the patient performs final assessment to determine if they can safely return to all activities of daily living before formal discharge from physical therapy. Once discharged, the patient is encouraged to maintain shoulder flexibility and strength with an independent exercise program.

-Rebecca L. Deal, MSPT

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