Arthroscopic Rotator Cuff Repair

The recovery process

Rehabilitation after rotator cuff repair is a structured, four-stage process designed to protect the repaired tendon while gradually restoring movement, strength, and function.

Your rehabilitation will be guided by your physiotherapist and tailored to your individual progress. Individual variations may be advised by Dr Richard Dallalana or your treating physiotherapist.

General guidelines

Stage 1: Protection and basic movement (Weeks 0–6)

During the first phase, the focus is on protecting the implanted joint and beginning gentle movement. Use ice for the first week to help with pain and swelling

Sling Use

A sling is needed for the first 4 weeks.
It is not full-time Unless advised otherwise the sling is not needed when in your home, nor in bed at night. Use a sling when walking around out of the home, or within the home only when walking for any extended period e.g. around the garden. The sling can be removed and both hands used freely to write, type, eat and assist with dressing and with personal hygiene.
The sling should be loose fitting, and no waist strap should be used
The sling is used to protect from excessive movement and use, from sudden rapid movement and from other people. It is not there to support the weight of the arm as such.

Use of the arm

Simple daily tasks including desk work
Avoid lifting any heavy items or forceful pushing or pulling with the affected side
Movements are restricted and forceful use discouraged in the first 6 weeks to protect the subscapularis muscle repair - this is a part of the rotator cuff group of muscles at the front of the shoulder. It is cut to allow access and then repaired with internal stitches at the end of the replacement procedure. Protection of this muscle repair is important in the long-term success of the anatomic shoulder replacement
You cannot drive a vehicle in this time

Exercises

Maintaining mobility in the elbow, wrist, and hand
Scapular setting (posture) exercises
Perform the exercises shown at least 3 times per day at home, unless pain prevents this.
Progression of active-assisted exercises (helping move your arm using your other arm or equipment such as a stick or pulley)

Your sling is discontinued after 6 weeks

Stage 2: Motion development (Weeks 6–12)

Weeks 6–9: Expanding movement and light strength

This phase includes:

Formal physiotherapy sessions beginning at 6 weeks to guide and advance exercises and optimise the final outcome
Increased range of motion in all directions, including gradual external rotation (rotation outwards to the side), to maximum extent. No movement range restrictions apply at this stage
Rotation behind the back (internal rotation) may be commenced, and is expected to be a little uncomfortable initially
Light strengthening of the shoulder muscles – Isometric contraction exercises
More active use of the arm in daily activities

Driving is resumed during this stage.

Weeks 9–12: Building strength and control

Continue regular physiotherapy visits and 3 x daily exercises at home

Stage 3: Strength and control (Weeks 12–20)

3 to 6 Months: Advanced recovery

Peak range of motion and strength is obtained by 12 months, occasionally up to 2 years for some muscles. Formal physiotherapy can cease between 4 and 6 months after surgery depending on progress, however ongoing home exercising is useful to derive maximum benefit.

Stage 4: Advanced strengthening and return to function (Weeks 20–12 months)

3 to 6 Months: Advanced recovery

Modifications to your rehabilitation

Your rehabilitation program may be adjusted depending on your specific procedure and tear characteristics:

Important note

These guidelines provide a general framework for recovery. Any specific instructions provided by Dr Richard Dallalana, whether written or verbal, should be followed in preference to these guidelines.

Can shoulder or elbow surgery help with ongoing pain?

In appropriate cases, modern orthopaedic techniques may help reduce pain, improve strength and mobility, and support a more active and confident lifestyle. Outcomes vary depending on your condition and individual circumstances.