The Rotator Cuff
The shoulder joint is a ball and socket joint with the head of the humerus (upper arm bone) sitting inside the joint. The rotator cuff is composed of four muscles that are attached by their tendons to the humerus and form a cuff around the top of this bone, functioning to both control and stabilize the head of the bone as it moves in the joint. Each muscle moves independently to create the different movements of the shoulder – forward, backward, and rotation. When the cuff is torn, often by a traumatic injury or chronic inflammation, mobility is hindered, resulting in pain and loss of function.
Rotator Cuff Repair and Recovery
If you have already had, or are anticipating surgery, it is because the injury is either severe, or has not improved with more conservative measures. A rotator cuff repair entails reattaching the tendon to the humerus bone. After surgery, strict adherence to postoperative care and activity instructions is essential to regain adequate function of the shoulder. It generally takes about 6 months of rehabilitation for the shoulder to return to normal. While your surgeon will give you specific postoperative instructions, the following are a general outline of what you can expect.
Most patients will need to wear an abduction brace for about 6 weeks. This will help prevent undue stress on the joint and prevent a reoccurrence of injury. Right after surgery, you will be allowed to use your hand, elbow and wrist for simple movements such as eating or holding a phone. You may also be allowed to drive. However, it is important to remember that the arm must be kept right at your side whenever the abduction brace is not on. And don’t anticipating being allowed to raise your arm above your shoulder for about 3 months.
Patients with less extensive injuries and repairs will be able to start rehabilitation with a licensed physical therapist sooner than those with more severe injuries. Initially, the rehab will include passive range of motion (ROM) exercise without resistance, which means the joint will be moved by someone other than yourself, like your therapist. You may also do active ROM without resistance, and maybe even active ROM with light resistance. You can expect to advance to light shoulder exercises above your shoulder at about 3 months, and will continue then to increase resistance to improve strength. While six months may be the expected rehabilitation period, it could take up to 2 years to return to the level of strength you had before your injury.
Your return to work will depend on the type of work you do. If you have a job that does not place a great deal of physical demands on you, you may be able to return in a week. If light duty is an option at your place of employment, a week is also a reasonable estimate. However, if your job requires manual labor, it may be up to 6 months before you will be able to return. In the mean time, expect you physical therapist to customize your rehabilitation to prepare you to return to your job with adequate strength and function of your shoulder.
If you have sustained a shoulder injury, or you have any question regarding the information provided, or you have any other orthopedic problems, please contact our offices in St. Peters or O’Fallon, MO. One of our specialists will be happy to see you to address your concerns.