Physical Therapy After Rotator Cuff Surgery
The rotator cuff is a set of muscles and tendons that surround the shoulder joint and stabilize it to prevent dislocation. However, occasional intolerable stress on these muscles may trigger a tear, necessitating a surgical procedure and physical therapy after rotator cuff surgery.
Physical therapy can help reduce pain and speed up your recovery after rotator cuff surgery. Notably, it’ll assist you in regaining strength and function in your shoulder, allowing you to get back to doing the things you love, like sports or household chores.
In this article we’ll answer the key questions about the process - how does it work? How long is physical therapy for the rotator cuff? And what exercises should you opt for to get the most out of it?
Let’s look at the basics of physical therapy after rotator cuff surgery, so you know what to expect from your recovery and how to optimize your results with physical therapy.
What Is Rotator Cuff Repair Surgery?
Rotator cuff surgery is a surgical technique employed in repairing a torn tendon in the shoulder. A surgeon may perform this procedure through shoulder arthroscopy (which utilizes smaller incisions) or an open (large) incision.
The rotator cuff is a band of muscles and tendons around the shoulder joint. These muscles and tendons keep the arm in place and aid in the movement of the shoulder joint. However, we may sometimes place unbearable stress on our shoulders, and such injury or overuse may result in a tear of the tendons in this area.
The good thing about physical therapy for rotator cuff surgery is that it helps facilitate physical fit following rotator cuff injury. Namely, it makes the recovery process from rotator cuff surgery quicker and more efficient. For example, biological treatment for rotator cuff injury focuses on stretching the shoulder, strengthening the shoulder, and facilitating a full range of motion.
One of the perks of physical therapy for rotator cuff surgery is its role in addressing swelling. Moreover, physical therapists use several techniques to reduce swelling after rotator cuff surgery, such as ice and elevation or laser treatment.
How Is Rotator Cuff Surgery Performed?
Rotator cuff surgery is a surgical treatment generally done in an operating room under anesthesia. During this procedure, the surgeon removes a small part of the bone, thick tissue, and nerves from the muscles. It also entails repairing or tightening the tendons to prevent re-injury.
The process of repairing a rotator cuff injury is usually via one of these three techniques:
1. Open Repair: A surgical incision is created during open repair, and the surgeon gently pushes a big muscle (the deltoid) out of the way to allow for surgery. This technique is usually reserved for larger or more intricate rips.
2. Arthroscopy: An arthroscope is introduced through a tiny
incision during arthroscopy - a minimally invasive medical procedure for diagnosing and treating joint problems. A video monitor is connected to the scope, enabling the surgeon to catch sight of the shoulder’s inside. About 1–3 additional tiny incisions are also made to allow for the introduction of additional equipment.
3. Mini-Open Repair: Here, an arthroscope is employed to repair or remove damaged bone spurs or tissue. In the open stage of the procedure, a 2- to 3-inch (5- to 7.5-centimeter) incision is created to access the interior. The rotator cuff is then repaired through this incision.
The process behind the rotator cuff repair involves the reattachment of the tendons to the bone. Suture anchors in the form of small rivets often enable this reattachment. These anchors usually comprise some dissolvable material or metal, which is why they don’t require eventual removal. Afterward, stitches or sutures are connected to the anchors, helping to keep the tendon and bone together.
Importance of Physical Therapy After Rotator Cuff Surgery
Physical therapy after rotator cuff surgery is critical to regaining full shoulder function. Only approved motions can reduce the danger of rotator cuff tendon retear, limit pain, and enhance maximum recovery.
Credits: Verywell/ Cindy Chung
Following rotator cuff surgery, a physical therapist will help you achieve the following:
● Increase your range of motion and circulation.
● Improve your arm strength.
● Prevent contractures with gentle stretching exercises.
● Loosen muscle fibers in the joint capsule
● Reduce swelling, stiffness, and discomfort.
● Reduce scarring and damage on your rotator cuff surgery.
● Achieve your functional goals via personalized workouts.
Physical therapy is essential for a full recovery following rotator cuff surgery. So, how long is physical therapy for rotator cuff injury?
Physical therapy will take at least six months to fully restore strength and range of motion.
It’s essential to do the exercises prescribed by your physical therapist as well as any additional recommended exercises to regain mobility and function.
Finally, get a doctor’s approval before starting any physical therapy after rotator cuff surgery, so you don’t risk additional shoulder injury or delayed recovery.
How Many Weeks of Physical Therapy Do You Need for Rotator Cuff Surgery?
The moment a patient is cleared to leave the hospital is when to start physical therapy after rotator cuff surgery. Patients will attend two physical therapy (PT) sessions per week for a set of weeks, depending on how severely they were injured.
Some patients may need only four weeks (one month) of PT, while others may need to do 12 weeks (three months) or more before they’re discharged to return to work. The severity and type of injury will depend on the stage of damage or tear sustained in other aspects of the shoulder joint. For example, is it a nerve and tendon injury or dislocation?
Ultimately, physical therapy for rotator cuff surgery includes exercises that help strengthen muscles and restore a range of motion in your arm.
Physical Therapy After Rotator Cuff Surgery
To prevent problems associated with the shoulder joint after surgery, there are four main phases of recovery. They include flexion, extension, adduction, and abduction. With all four stages, the movements must be slow and controlled, not forceful.
Accordingly, here are the explained experimental phases that will help you regain your strength:
Passive Range of Motion Phase
Physical therapy for rotator cuff surgery recovery starts with a passive range of motion phase, followed by more intensive treatment. In the passive range of motion phase—lasting about six weeks—you must wear a sling almost all the time and keep your arm immobilized to protect your repaired tendons.
Passive range of motion exercises simply involve moving the shoulder through its complete range of motion while another person moves the arm back and forth in each direction.
These exercises help prevent stiffness and to help get your joints used to working together again. In other words, during these rotator cuff exercises after surgery, physical therapy helps mobilize your shoulders to prevent tension buildup in rotator tendons and muscles.
Your physical therapist also educates you on mobilizing your shoulder while avoiding the contraction of your rotator cuff muscles. The good part is that you may repeat these activities at home if you have someone to assist you.
Active Range of Motion Phase
In this phase, you’ll need to perform more agile motion exercises, like active shoulder extension and active elbow flexion. Although this stage requires you to move your arm without assistance, you’ll need to undergo these exercises without introducing extra weight. At this stage, the tendons in your shoulder should have experienced considerable healing.
Your physical therapist will educate you on movement routines and stretches for arm control enhancement and muscle strengthening. Being part of physical therapy for rotator cuff tear after surgery, these exercises also help minimize stiffness and increase your motion range.
Often, your physical therapist will set up a specific timeline for this phase, but it’ll vary depending on your recovery speed. While it can last up to 12 weeks, you can enjoy better long-term recovery if you repeat these exercise routines at home. So, if you’re curious about the question, “how long is physical therapy after rotator cuff surgery?” This should give you an idea.
Advanced Strengthening Phase
At this stage, your physical therapist will focus on helping you reach your previous level of function with exercises. Your tendons and rotator cuff tendons and muscles have undergone sufficient healing at this stage, allowing for engagement in exercise routines that enable muscle strengthening.
Since a lack of muscle activity can trigger muscle atrophy (thinning/wasting of muscle mass), your physical therapist will educate you on how you can strengthen your shoulder muscles. This involves the use of minimal stretching, resistance bands, and minimal weights.
Return to Activity Phase
The last phase of your physical therapy for rotator cuff surgery is to return to your regular activity. So, it would help if you started post-operative exercises at home by engaging in tolerable training, bracing and splinting, and scar management exercises.
Your physical therapist will teach these different postoperative treatment techniques in individual sessions, which generally last about 45 minutes. If needed, these sessions may continue for up to several weeks after discharge from the hospital.
Precautions After Rotator Cuff Surgery
While physical therapy for rotator cuff surgery recovery is recommended to restore shoulder function, it’s beneficial only when done correctly. This means you shouldn’t engage in activities that may impede your recovery process after surgery.
Here’s a list of things to bear in mind after undergoing a rotator cuff surgery:
● For the first four weeks after surgery, don’t raise the operative arm over 70 degrees in any plane.
● For the first six weeks, avoid lifting anything heavier than 5 pounds with the operative arm.
● Avoid extreme reaching and external/internal rotation for the first six weeks.
● Endeavor to utilize an abduction cushion in the first four weeks after surgery. However, wearing a sling while sleeping is optional and depends on personal preference.
If you’re recovering from this type of surgery, here are a few essential things to keep in mind: First, be patient with the healing process; it may take as long as two years to see improvement, and some people never regain full range of motion.
Second, avoid heavy lifting or strained movement; you must be careful about what you do and how much weight you place on your shoulders, as excessive weight can cause damage.
Third, start engaging in gentle movements immediately to help get your blood flowing again and gradually increase activity until you fully recover.
Physical therapy after rotator cuff surgery is an excellent way to speed up your recovery and regain optimal arm and shoulder movement. The therapists and healthcare professionals at Miracle Rehab Clinic create an individual treatment plan for each patient to achieve the best results.
Contact Miracle Rehab Clinic today to book an appointment.