Tearing the rotator cuff in your shoulder can require surgery and months of physical therapy. This is a complicated structure that involves many muscles, tendons and ligaments. The best way to insure that you have a successful recovery and gain back full use of your shoulder is to be patient and follow the recommendations of your doctor. Here is what you can expect during the recovery period and how to make sure it is a complete success.
Anatomy of a Rotator Cuff Injury
Multiple tendons form a capsule in your shoulder that contains the upper part of the humerus, your upper arm bone. Ligaments hold the bones together within this capsule, but allow the shoulder joint to move through its full range of motion. Muscles have an extensive blood supply, tendons have less and ligaments have very little. This effects the speed at which these tissues heal.
Depending on the extent of the injury, a torn rotator cuff can involve muscles, tendons and ligaments. The capsule around the joint becomes swollen, resulting in a stiff shoulder. Your shoulder surgeon will repair torn tendons and ligaments which starts the long recovery process. Because of the limited blood supply in those tissues, healing is slow and the tissues are vulnerable to re-injury during that time.
First Steps to Recovery
Your doctor will send you home with your arm in a special sling that holds the arm snug against the body. This prevents the shoulder from moving. You'll wear this sling constantly, only taking it off to clean up. It may take weeks for the tendons and ligaments to heal, during which time they could become re-injured if you move your shoulder suddenly or too far. When your doctor is satisfied with the tissue healing, you'll begin physical therapy on your shoulder.
Passive Therapy to Regain Flexibility
The physical therapist will begin by moving your shoulder through its normal range of motion to slowly stretch out muscles that haven't been used in weeks. Your therapist will show you exercises that you can do with your other arm and hand moving the affected shoulder. This will continue for several weeks until your shoulder has its full range of motion and no tense muscles. You'll continue to use the sling most of the day, when not exercising.
Active Physical Therapy to Strengthen Muscles
With full range of motion back, you will begin doing exercises to build up the strength in your shoulder muscles. You will continue to work with a physical therapist, but much of the muscle strengthening you'll do on your own. You'll also be able to go without the sling for longer periods and begin to use your shoulder for light tasks. This strengthening phase will also require several weeks of conditioning.
All of this effort gets you to the point where you can use your shoulder for normal daily activities. If you're an athlete or just enjoy playing sports, you'll spend several more weeks strengthening the shoulder to prevent another injury out on the playing field.
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