Most rotator cuff tears can be treated without surgery. But sometimes surgery is the only way to strengthen the upper arm and free a patient from pain.
Sometimes, surgery is done right after an injury. Other times, surgery may be a last resort after other treatments have failed.
It’s understandable to fear the prospect of surgery. But it should come as a relief to know that the procedure is straightforward. Many patients feel that rehabilitation and recovery is more challenging.
This article explains what to expect as you heal and recover from rotator cuff surgery. It’s a four-phase process that can take from four to six months, sometimes longer.
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 in a sling. A sling that holds the arm slightly away from the side (an abduction sling) is generally recommended after rotator cuff repair surgery.
A sling of this type holds the tendons in a more relaxed position. You probably will be glad you have it.
You will remain at the outpatient center until your pain is under control.
The First Days After Surgery
Expect that the first days after rotator cuff surgery will be focused on controlling your pain. Your healthcare provider should prescribe medication to help.
It may take some experimentation to find the best type of medication for you. Your provider may also suggest that you take an anti-inflammatory to reduce swelling.
You (or your caregiver) can also expect to make multiple trips to the freezer for ice packs. Icing the shoulder plays a crucial role in pain control.
Sleeping at Night
Sleeping after shoulder surgery may be your biggest challenge. Even a moderate ache in the shoulder can prevent a good night’s sleep.
Many people sleep in a semi-upright position after rotator cuff surgery. In this case, sleeping in a recliner can be ideal.
If you don’t have a recliner, ask your caregiver to gather a mass of pillows so you can create your own puffy backrest. Sleep sitting upright with your elbow pointed downward.
Ask your physician whether taking a sleep aid is a good choice for you. Sleep will be vital to your recovery. It will give you the strength you need to face the daily challenges ahead.
Recovery Phase 1: Passive Motion
The first phase of recovery is passive motion only. This means that only a physician or physical therapist should move your shoulder for you.
Passive motion also means that the rotator cuff muscles and tendons do no work on their own. The shoulder moves without placing any tension on the repair.
This phase may last up to six weeks, depending on the size of the rotator cuff tear and the strength of the repair itself.
It may feel “funny” to have a therapist move your shoulder for you. But it should be helpful: Toward the end of this phase, the therapist can explain how to move your own shoulder without contracting the rotator cuff muscles.
Recovery Phase 2: Active Motion
The active motion phase begins when the tendons heal enough for you to start moving your arm on your own.
A physical therapist may work with you to strengthen your muscles, reduce shoulder stiffness, and improve your arm control. Expect to do home exercises to increase your range of motion, too.
The exercises likely won’t involve any added resistance during this phase. This can be a long phase—taking up to 12 weeks from the day of surgery.
Recovery Phase 3: Strengthening
The strengthening phase of recovery is the most important.
It may help to remember how the injury, surgery, and early phases of recovery have weakened your muscles. Now you must work to strengthen them so you can return to your normal activities.
Many patients are happy to know that they do not need to lift heavy weights in this phase. A skilled therapist can show you how to use resistance bands or light weights to strengthen your arm and still get an excellent workout.
Recovery Phase 4: Full Activity
Full recovery after rotator cuff surgery often takes four to six months. Complications can extend this timeline.
Recovery time often depends on:
The size of the rotator cuff tearThe severity of the tearThe outcome of the surgeryThe patient’s commitment to rehabilitation
Keep in mind that there is no one-size-suits-all treatment plan. Everyone moves through these phases at a different pace.
Your physician should play an active role in your recovery. Place a call when you need help, because a delay could set your recovery timeline back.
Summary
No one would ever say that recovering from rotator cuff surgery is easy. It often takes about six months. Expect to go through four phases: passive motion, active motion, strengthening, and full activity. Your exercises will increase in intensity in each phase. Take it slow and steady and you’ll soon feel like yourself again.
A Word From Verywell
Remember that this is a general outline of the phases that follow rotator cuff surgery. Every patient, every tear, and every surgery are a little different.
It can be tempting to compare your progress with that of friends, family members, or other patients you meet at therapy. But their recovery plan and progress may be very different from yours. So try not to compare notes.
