- The rotator cuff consists of 4 muscles, the supraspinatus, infraspinatus, teres minor, and subscapularis. Each of these muscles has its own tendons that originate from different areas of the scapula. The tendons control the motion of the shoulder. Surgery of a torn rotator cuff consists of repairing one of these tendons, which the most common one is the supraspinatus tendon.
2. A torn rotator cuff can occur due to not tending to or ignoring shoulder pain. It may start out as tendonitis, which is inflammation of a tendon, then gradually progresses to a tear. Worsening of pain from tendonitis then causes other problems such as weakening of muscles and stiff range of motion. However, the point of rotator cuff tendonitis progressing into a tear may even go unnoticed to some. In contrast, a torn rotator cuff could occur suddenly. For instance, falling onto an outstretched arm or attempting to lift a heavy object in a jerking motion could cause a sudden rotator cuff tear.
3. Even though you are having surgery to repair your rotator cuff, there are several other muscles that get affected with surgery. The biceps, latissimus dorsi, pectoralis major and minor, upper trapezius. These muscles begin to get tight because of being in a sling for 4-6 weeks. Part of your physical therapy post-surgery will include manual therapy and stretching to these muscles to help increase your range of motion.
4. The common two types of surgery for a torn rotator cuff are an open repair and an arthroscopy. The open repair involves the surgeon creating an incision (about 5 cm) and moving a large muscle out of the way to perform the surgery. In comparison to an arthroscopy, it involves creating several small incisions (about 5mm) then inserting instruments through them to perform the surgery. One instrument is a scope connected to a video monitor, which will allow the surgeon to see inside of the shoulder and work accordingly. As you would probably guess, the open repair is more commonly used for large and more complex tears, whereas the arthroscopic is viewed as less invasive.
5. After surgery, patients usually find themselves in a splint for 4-6 weeks while attending physical therapy. Recovery rates vary per patient, but the majority tend to need 3-6 months of therapy post-operation. Physical therapy will help regain range of motion and strength in the shoulder. The range of motion is very limited at first, due to pain as well as stiffness from being in the splint. It is so important to be committed to physical therapy in order to properly allow the shoulder to heal and return to its normal function. You must follow your surgeon’s directions on easing into your exercise protocol. Attempting to do too much, too early can greatly increase your risk of re-tearing your rotator cuff.
Physical therapy after a rotator cuff repair is a difficult road. At Movement Physiotherapy we realize how important and delicate rotator cuff physical therapy is. We provide 1 on 1 care for post-op rotator cuff patients, that is one Doctor of physical therapy to one rotator cuff patient. We watch and instruct on every exercise and stretches performed. We know how easily exercises can get misinterpreted in a PT clinic that operates like an “assembly line”. We focus on a more personal experience at Movement Physiotherapy, not worrying about seeing 4-5 patients at a time.
At Movement Physiotherapy we specialize in manual physical therapy for the shoulder and focus early in treatment to increase our patient’s range of motion with joint mobilizations, manual myofascial release, and instrument-assisted soft tissue mobilization. We also make sure we contact your surgeon and let them know how you are progressing and if we feel like you need a sooner follow-up.
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