FAQ – Rotator cuff tear

What are the things to expect after Arthroscopic Rotator cuff repair?

Pain

It is normal to feel some pain following your operation. You will be given some painkillers and/
or anti-inflammatory medication to take in the days following the operation.

Using ice on your shoulder can be helpful in reducing pain. Wrap a bag of crushed ice, or frozen peas in a damp towel.

Protect your dressings from getting wet with a layer of cling-film, or a plastic bag, before applying the ice pack for 10-15 minutes at a time.

Posture can make a big difference to your pain after surgery. Avoid ‘hitching’ your shoulder or holding it in an elevated position. Try to avoid slumping or standing/sitting with round shoulders as this puts more stress onto your shoulder.

Getting back to normal

It is normal to feel more tired than usual for a few days after having an operation. Sleeping can be uncomfortable and it is important to try not to lie on your operated shoulder. You should wear your sling in bed for the first 3-6 weeks (your Physiotherapist will advise you) to protect your shoulder.

Using pillows to support your operated arm and maintain your posture when sleeping will help with the discomfort.

Washing and dressing

Dressings and bandages that are applied in theatre need to stay dry. Remove your sling when bathing or showering, but keep your arm close to your body. Ensure that the area is dry before dressing to prevent irritation in the armpit. It is easier to wear looser fitting clothes and dress by putting your operated arm into position in the top first.

Wound care

Your wound also needs to stay clean and dry. If you have removable stitches they will be removed after 10-14 days at an outpatient clinic appointment or by your GP. If dissolvable stitches are used, they will not need to be removed.

Rehabilitation

Rehabilitation is important if you are to get the most out of your shoulder after the operation. You should be given information about your first physiotherapy appointment before you leave hospital. The amount of physiotherapy you will need will depend on your individual progress and the level of activity you wish to return to.

Returning to work

The amount of time you have off work depends on your job. If you have a manual job, or one that involves lifting or overhead activities, you will not be able to do this for 8-12 weeks. Please discuss this with your Consultant or Physiotherapist.

Driving

You should not drive until you have discussed your progress with your Consultant / Physiotherapist which will not be until at least 6 weeks following your operation. You must be able to comfortably control your vehicle and perform emergency manoeuvres.

Sports and activities

The timescale for which you can go back to any previous sport or activity will depend on your movement and strength and the particular activity you have in mind. Please discuss returning to any activity or sport with your Consultant or Physiotherapist.

Post-operative exercises

With all of your exercises you should aim to repeat 10 repetitions, 3 times a day unless otherwise advised by your Physiotherapist.

1. Active hand and wrist exercises with forearm supported

It is important to keep your hand, wrist and elbow moving after shoulder surgery

• Use your non-operated hand to support the forearm on your operated side. Move your wrist up and down and side to side as far as you are comfortable
• With the same support, make a fist and then stretch your fingers as far as you can
• Slowly turn your forearm over so your palm faces up and then down

2. Passive elbow exercises 

• Sit with good posture
• Use your non-operated hand to grip the forearm on your operated side
• Use the non-operated arm to slowly bend your elbow as far as you are comfortable and then straighten it as far as you are comfortable

3. Passive external rotation to neutral

• Rest your elbow on a table or the arm of a chair, keep the elbow of your operated arm into your side
• Use your non-operated hand to move your hand away from your stomach to the position shown in the photograph. Do not push any further

4. Passive flexion to 90 degrees

• Lying on your back, allow a friend or relative to move your arm towards 90 degrees by supporting around your wrist and elbow
• Only allow your arm to be moved as far as is comfortable or to 90 degrees maximum

Important things to remember following your rotator cuff repair

1. Continue to wear your sling day and night as requested by your Consultant
2. Do not lift your operated arm without assistance until it is allowed out of the sling
3. Do not use the unoperated arm for any heavy manual work whilst in the sling

These are important to protect the repair of the tendons.

Can a rotator cuff tear heal without surgery?

Rotator cuff tears do not heal on their own without surgery, but many patients can improve functionally and decrease pain with nonsurgical treatment by strengthening their shoulder muscles. Just because there is a tear, does not necessarily mean a surgery is needed. Especially, if the MRI scan reports a partial thickness tear which involves less than 50 percent of the thickness of the cuff muscle, it might respond to conservative measures including focused physical therapy.

What are nonsurgical treatments for rotator cuff tears?

Rotator cuff tears do not heal on their own without surgery, but many patients can improve functionally and decrease pain with nonsurgical treatment by strengthening their shoulder muscles. Just because there is a tear, does not necessarily mean a surgery is needed. About eight out of 10 people with partial tears get better with nonsurgical treatments. It can take up to a year for the condition to improve.

Nonsurgical treatments include:

• An arm sling and rest to give your shoulder time to heal. You may need to modify activities and stop certain work or sports for a period of time.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) to minimize pain and swelling.
• Physical therapy to learn strengthening and stretching exercises.
• Steroid injections to ease pain and swelling.

How can I prevent a rotator cuff tear?

To prevent a rotator cuff tear, it’s important to keep your muscles and tendons flexible. Your healthcare provider can teach you stretching and strengthening exercises to do at home.

When should I consult a surgeon?

You should consult your healthcare provider if you experience:

• Chronic shoulder and arm pain.
• Pain that worsens at night or interferes with sleep.
• Redness, swelling, or tenderness in the shoulder joint area.
• Shoulder or arm weakness.

What are the complications of a rotator cuff tear?

A rotator cuff tear can get worse without treatment. A complete tear can make it almost impossible to move your arm. Without treatment, you may have chronic shoulder pain and find it very difficult to use the injured arm.