A discussion with a physiotherapist
Dr Kenneth Cutbush has recorded a discussion with physiotherapist Lucy Angelini on rehabilitation after rotator cuff repair. The surgery itself is only the beginning: what happens over the months that follow does a great deal to determine the result, and the conversation is aimed at patients, clinicians and physiotherapists alike.
Physiotherapy before surgery
The discussion begins before the operation. Pre-surgical physiotherapy is used to address stiffness, to work on the position and control of the shoulder blade, and to teach the exercises and precautions that will be needed afterwards, so that they are already familiar. Going into surgery with a shoulder that moves reasonably well and with a clear idea of the early routine tends to make the first weeks more straightforward.
The first days after surgery
The conversation then covers what to expect from day one on the ward. The repaired tendon needs to be protected while it heals to bone, so the early period is generally about comfort, managing the sling, and carefully supervised movement rather than active use of the arm. Our rotator cuff repair page explains what the operation involves.
Milestones along the way
Four points are discussed as markers of progress: around six weeks, around twelve weeks, around six months, and beyond. Broadly, rehabilitation after a cuff repair moves through a protective phase, then a phase of regaining passive and then active movement, then a strengthening phase, with return to heavier work and sport later still.
These timings are indicative only. The actual programme depends on the size and pattern of the tear, the quality of the tendon and bone, what was done at surgery, and how an individual shoulder responds. Your own protocol, as set by your surgeon and physiotherapist, is the one to follow, and it may differ from the general pattern above.
Strength, mobility and the shoulder blade
The later stages cover strengthening, mobility and scapular positioning. The last of these is easy to overlook: the shoulder blade is the base the arm works from, and if it does not sit and move well the repaired cuff has to work harder. A good deal of later rehabilitation is therefore directed at the muscles controlling the shoulder blade rather than the cuff alone. The rehabilitation page sets out the general approach.
Watch the discussion
The full discussion is available via this link: watch the video.
Further reading
If you have been told you have a cuff tear and are deciding what to do, our rotator cuff tear page explains the condition and the non-surgical options, which are appropriate for many people. The surgery FAQs cover the practical questions, and you can arrange an assessment via the consultation page.