What to expect after your rotator cuff repair!
You injured your shoulder, been to the physio and had an extensive rehabilitation program, tried a corticosteroid injection and now the orthopaedic surgeon suggests having an operation. That torn rotator cuff is just not getting better and you still can't wash your hair properly or reach the champagne flutes in the kitchen cupboard.
Having surgery is an important choice. There are risks and rewards that you and your surgeon will discuss, and you should be aware of these prior to making your decision. Your surgeon will choose a surgery technique that is going to give you the best outcome. Every rotator cuff tear is different and the operation that your friend had might not be what is best for you.
You have had your surgery and woken up to find your arm in a sling and a set of instructions to move your wrist and elbow over the next couple of weeks. You will see the surgeon again in a couple of weeks to have any stitches removed.
Won't my shoulder stiffen up if I don't move it? When can I start driving? When can I get back to work? Will I wreck the repair if I use the shoulder too much? It hurts when I do my exercises?
These are all questions I regularly get asked by patients after their shoulder operation. There are different answers for every patient according to their circumstance.
If you don't move your shoulder - IT WILL stiffen up, but there is a balance between protecting the repair and allowing it to heal and preventing tightness from non use. Generally you will be in a sling for up to 6 weeks but vowed to remove the sling to exercise the shoulder and arm several times per day. Physiotherapy will start soon after your operation and involve manual therapy and passive
exercises. Active assisted exercises can start some time after 2 weeks - this means you can start using some of the muscles around the shoulder to help you move, but they need some help from your other arm.
Shoulder strengthening exercises start fairly early on in rehab - at around the 6 week mark post op. We usually start with isometric exercises before progressing to resistance exercise using weights and/or theraband. SO WHEN CAN I START DRIVING?
When you are capable and safe to do so!! There is so set time frame. You need to be able to have enough strength in your shoulder and arm to turn the steering wheel sharply. Doing this under load too early can cause the repair to fail. You will be surprised at how tired your shoulder gets after a relatively short drive, the first few times you do it?
MY SHOULDER HURTS WHEN I DO MY NEW EXERCISES!!!
With each new activity you do post op there is generally some new pain associated with it. It is normal as long as the pain is not too great and settles with rest. Persistent pain may have to be managed by reducing the load or number of repetitions of the exercise you are doing. We will gradually build it back up again.
BUT I MIGHT DAMAGE THE REPAIR IF I LIFT SOMETHING HEAVY!!!
There is lots research that has been done on rotator cuff repairs so we know that the repair
can withstand certain loads at certain points in time after your operation. If you stick to the plan given to you by your physio you won't have any problems with this. perhaps the most dangerous time is when the shoulder starts feeling really good, but doesn't quite have the strength in it just yet.
GETTING BACK TO WORK!!
Is very dependent on the work that you do. Someone who works in a call centre may be back at work far quicker than a plumber working on his own. Your physiotherapist will help guide your return to work as well as providing you with an exercise program geared towards the job or sporting activity that you do.
From 12 weeks until 24 weeks your shoulder strengthening exercises will be gradually progressed and work and sport specific activities will be introduced towards the end of this time.
Physiotherapy is a very important component of success of rotator cuff surgery. Without it, it is highly unlikely you will have a well functioning shoulder six months following surgery. Without the graduated strengthening program supervised by your physio rates of repair failure or re-injury increase.
Key points about rehabilitation following rotator cuff repair;
Don't leave it too long after surgery to start physio
Every journey is different
Be diligent with your exercises
Don't be afraid to ask questions
