What is a rotator cuff repair?
The rotator cuff is a group of four tendons that hold the ball of the shoulder in its socket and lift and rotate the arm. When one tears, the surgeon stitches the tendon back to the bone, usually by keyhole surgery. Our page on rotator cuff shoulder pain explains what happens before surgery.
The repair is only the start. A stitched tendon is weak until it heals, and the shoulder gets stiff if it is held still for too long. Rehab protects the repair, then returns movement and strength in a planned order.
Why does rehab go in stages?
Because the repair has to heal before it is loaded. The stages follow the surgeon’s protocol, which depends on the size of the tear and the quality of the tendon.
- Protection. The arm rests in a sling. Hand, wrist and elbow movement keeps the rest of the arm active.
- Passive movement. The arm is moved for you, with your own muscles relaxed.
- Active movement. You start to lift the arm yourself, with the surgeon’s permission.
- Strengthening. Resistance is added gradually.
- Return to activity, such as cooking, carrying and sport.
Skipping ahead is the main risk. We move on only when your surgeon’s rules and your own tests agree.
What will the physiotherapist do?
The first visit is about safety. We read the surgeon’s instructions, check the sling fit and wound, and teach you how to move the elbow, wrist and hand. We show a relative or helper how to assist.
Later visits add shoulder range of movement, the shoulder blade muscles that support the arm, and light strength work. Throughout, we check for range of motion changes, stiffness and pain that signals you are going too fast.
How do I manage daily life with the arm protected?
Home is where the sling matters most. Dressing, showering, sleeping and eating all need a plan.
- Dress the operated arm first, and undress it last.
- Wear loose, front-opening tops.
- Sleep propped up, with a pillow under the arm, or in a recliner.
- Set up one-handed kitchen tasks, such as pre-cut vegetables and a stable board.
- Keep the other arm and the legs moving with short walks.
Our guide to shoulder pain at night has sleeping ideas, and the guide on surgeon rehabilitation instructions lists what to ask at each review. In an Ipoh home, we also look at the hot, humid climate. A damp sling or wound dressing needs care, and the surgeon will tell you how to keep it dry.
What can I do this week?
Follow the surgeon’s sling and exercise instructions exactly. In addition, prepare the home.
- Place daily items at waist height on the side of the operated arm.
- Practise getting out of bed without pushing on the sore arm.
- Arrange for someone to be home for the first physiotherapy visit.
- Write down what you want to do again, such as hanging laundry or lifting a grandchild.
- List your questions for the next review.
When should you call the surgeon or go to hospital?
Call your surgeon if the wound opens or leaks, the shoulder becomes hot, red and very swollen, you have a fever, or the hand goes cold, pale, blue or numb. A sudden pop or sharp pain after a fall also needs review.
Go to the emergency department for chest pain or breathlessness. Tell us afterwards so we can adjust the plan.
Home visit or Canning Garden centre?
Home visits across Ipoh are available now, and they suit the protected stage when travel is tiring. Our Canning Garden centre near Fatimah Hospital is opening soon, and may suit the later strengthening stage.
Prices differ for home and centre, and we give a quote on WhatsApp after a short description. Read about post-surgical rehabilitation and home physiotherapy.