A healthy living blog from Marshfield Clinic Health System

Rotator cuff surgery: Reconnect to a pain-free shoulder

Senior man stretching his arm - Rotator cuff surgery

Rotator cuff surgery followed by physical therapy restores range of motion and strength for many patients with shoulder injuries.

A rotator cuff injury is a real pain. A sudden injury causes sharp, intense pain and weakness. A degenerative injury causes dull, achy pain that may get worse over time.

Surgery may be recommended depending on the severity of the injury and symptoms. A full tear or a partial tear causing significant pain warrants surgery, said Dr. Thomas J. Bramwell, a Marshfield Clinic Health System orthopedic surgeon.

In most cases, the surgery is done using a minimally-invasive arthroscopic procedure. Sometimes a small open incision may be used as well. The surgeon re-attaches the damaged tendon to the bone using anchors and sutures.

Is rotator cuff surgery right for you?

Patients regain strength and range of motion after surgery. On the other hand, people with untreated rotator cuff tears may develop arthritis in addition to the existing shoulder injury.

“Someone who has severe arthritis or unhealthy rotator cuff tissue because of a longstanding injury may not be a candidate for rotator cuff repair surgery,” Bramwell said. “They would be facing another type of surgery, such as a shoulder replacement.”

The procedure is safe and has low risk of infection. People who smoke or have diabetes have higher risk of the tendon not healing to the bone properly. Bramwell recommends quitting smoking before surgery to improve chances of better healing.

Recovery starts with motion, then strength

Most people spend six weeks after rotator cuff surgery in a sling with an abduction pillow that holds their arm away from their body to remove tension from the shoulder. The goal is to allow the tendon to heal to the bone.

Patients start physical therapy to restore range of motion about six weeks after surgery. Physical therapists begin with passive motion, which means they do the work to move the arm in all directions. Later, they begin to work on active motion and strength with patients.

Restoring range of motion can take quite a bit of time after being immobilized,” Bramwell said. “If you can get your range of motion back, you can get your strength back.”

Most people return to normal activities in three to six months, depending on the physical demands of their lifestyle and job. Mobility and strength gains continue for a year after surgery.

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