Our Summary

This research paper is about how to best heal the shoulder after surgery to repair a tear in the rotator cuff, a group of muscles and tendons that stabilize the shoulder. The paper discusses the role of movement and rest in the recovery process. After such surgeries, some doctors recommend moving the shoulder early to promote healing, while others suggest keeping the shoulder still for a while to protect the surgical site. The healing process involves both biochemical and physical changes in response to how much load or stress is put on the shoulder. The study shows that controlled, moderate movement can help healing, but both complete rest and too much movement can actually be harmful. The paper supports its argument with several clinical studies examining the impact of movement on recovery after rotator cuff repair.

FAQs

  1. What is the role of postoperative rehabilitation in rotator cuff repair?
  2. How does early mobilization or immobilization after rotator cuff repair impact the healing process?
  3. What are the effects of complete load removal and chronic overload on the tendon-healing process after rotator cuff repair?

Doctor’s Tip

A helpful tip a doctor might tell a patient about rotator cuff repair is to follow the prescribed postoperative rehabilitation program carefully. This may include exercises to strengthen the shoulder muscles, improve range of motion, and gradually increase loading on the repaired tendon. It is important to avoid overloading the shoulder too soon, as this can increase the risk of re-tears. By following the rehabilitation program as instructed, patients can optimize the healing process and improve their chances of a successful outcome after rotator cuff repair.

Suitable For

Patients who are typically recommended for rotator cuff repair are those who have a torn rotator cuff that is causing pain, weakness, and limited range of motion in the shoulder. These patients may have tried conservative treatments such as physical therapy, cortisone injections, and rest, but have not experienced relief of their symptoms. Additionally, patients who have a large or complete tear of the rotator cuff, or who have a tear that is causing significant functional impairment, may also be recommended for surgery. It is important for patients to be evaluated by a qualified orthopedic surgeon to determine if they are a good candidate for rotator cuff repair.

Timeline

  • Before rotator cuff repair: The patient may experience pain, weakness, limited range of motion, and difficulty performing daily activities due to a rotator cuff tear. They may undergo imaging tests such as MRI to confirm the diagnosis and consult with a surgeon to discuss treatment options.

  • Rotator cuff repair surgery: The patient undergoes surgery to repair the torn rotator cuff tendon. The surgeon may use arthroscopic or open techniques to access and repair the tendon. The surgery typically lasts a few hours, and the patient is usually able to go home the same day.

  • Immediately after surgery: The patient will be given pain medication and instructions on how to care for the surgical site. They may need to wear a sling to support the shoulder and limit movement. Physical therapy may begin soon after surgery to help restore range of motion and strength.

  • Weeks to months after surgery: The patient continues with physical therapy and gradually increases the intensity of exercises to strengthen the repaired tendon and surrounding muscles. The focus is on improving shoulder function and preventing re-injury. The surgeon may recommend restrictions on certain activities to protect the healing tendon.

  • Long-term: The patient may experience improvements in pain, strength, and range of motion over time. It can take several months to a year for the tendon to fully heal and for the patient to regain full function of the shoulder. Follow-up appointments with the surgeon may be scheduled to monitor progress and address any concerns.

What to Ask Your Doctor

  1. How long will my recovery process be after rotator cuff repair surgery?
  2. What type of rehabilitation program will I need to follow after surgery?
  3. Will I need to wear a sling or brace after surgery?
  4. When can I start physical therapy after surgery?
  5. What restrictions or limitations will I have during the recovery process?
  6. How will you monitor my progress and what signs should I look out for that may indicate a complication?
  7. What can I do to optimize the healing process and reduce the risk of re-tears?
  8. Are there any specific exercises or activities I should avoid during the recovery process?
  9. How soon can I expect to regain full range of motion and strength in my shoulder?
  10. What are the potential risks or complications associated with rotator cuff repair surgery and how can they be minimized?

Reference

Authors: Hsu JE, Horneff JG, Gee AO. Journal: Orthop Clin North Am. 2016 Jan;47(1):169-77. doi: 10.1016/j.ocl.2015.08.017. PMID: 26614931