Physical Therapy After Rotator Cuff Surgery

Why Physical Therapy Matters After Rotator Cuff Repair

Your rotator cuff includes a group of four muscles and tendons that hold the ball of your shoulder in its socket and help you lift and rotate your arm. When a tear is big enough to need surgery, the surgeon stitches the torn tendon back down to the bone.

That tendon heals slowly, and for the first couple of months the repair is still fragile. Moving too much too soon can strain it, but barely moving at all can leave the shoulder badly stiff. Physical therapy helps you find the middle ground, moving the shoulder enough to keep it from locking up while the tendon heals.

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Rotator Cuff Repair Physical Therapy Protocol

Every surgeon has their own rotator cuff repair physical therapy protocol, and the timing depends a lot on how big the tear was. The stages below give a general picture of what recovery usually looks like.

Weeks 0 to 6: Protecting the Repair

You’ll wear a sling most of the time, usually including at night. Your therapist may move your arm for you, or show you how to move it with your other arm, but you won’t be lifting it with your own muscles yet. Sleeping propped up in a recliner or on a stack of pillows helps a lot of people get through this stretch.

Weeks 6 to 12: Moving on Your Own

Once your surgeon clears you out of the sling, you’ll start lifting and moving the arm yourself. It may feel weak and awkward at first, which is normal. Light daily tasks start coming back during this stage.

Around 3 Months and Beyond: Building Strength

Around three months after surgery, you may be ready to start strengthening exercises, depending on how well your tendon is healing. We'll slowly add more challenging exercises, including movements you need for work, sports, or everyday activities. Most people need at least six months to regain their strength, and recovery from larger tears can take a year or more.

If you notice a sudden increase in pain, significant swelling, drainage from your incision, or a fever at any point, contact your surgeon right away.

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Rotator Cuff Physical Therapy Treatment

Physical Therapy San Antonio

What you work on at each visit depends on where you are in the protocol. Your plan may include:

Rotator Cuff Physical Therapy Exercises

For the first several weeks, the goal is simply to keep your shoulder from getting stiff. That might look like your therapist gently moving your arm, or a pulley over a door that lets your good arm do the work. Once the tendon has healed enough, we’ll start strengthening the rotator cuff and shoulder blade muscles a little at a time, until lifting and reaching stop wearing your shoulder out.

Manual Therapy

Hands-on techniques may help ease stiffness in the shoulder and surrounding muscles, especially after weeks in a sling.

Orthopedic Joint Mobilization

When the joint itself has gotten stiff, gentle mobilization may be used once your surgeon’s protocol allows it.

Movement Control Training

A shoulder that’s spent weeks in a sling can move a little clumsily at first. These exercises help the muscles work together again so your arm moves smoothly when you reach or lift.

Practicing Everyday Tasks

Later in rehab, we’ll practice the movements you actually need, whether that’s putting dishes away on a high shelf, lifting at work, or swinging a golf club.

Kinesiology Taping

Tape may be used during certain exercises to give you feedback on how your shoulder is moving.

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Not Sure You Need Surgery?

Not every rotator cuff tear needs to be repaired. Physical therapy for rotator cuff problems like tendinitis, irritation, and some partial tears is often the first step, and many people improve without an operation. If you’re still deciding, or your doctor has suggested trying therapy first, our Rotator Cuff Injuries page covers physical therapy for rotator cuff issues that don’t involve surgery.

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