What Is the Rotator Cuff?

The rotator cuff is a group of four muscles and tendons that help lift and rotate the arm and keep the shoulder stable.

Types of Rotator Cuff Tears

1. Degenerative (Chronic) Tears

These tears develop gradually over time. They are most common in:

• Adults over age 40
• People with jobs or activities involving repetitive overhead use

Degenerative tears often begin small and can slowly enlarge. Symptoms may include:

• Pain at night or with overhead movements
• Gradual weakness

2. Acute Traumatic Tears

These occur suddenly from:

• A fall on an outstretched arm
• Lifting something heavy
• A sudden force or pull

These tears often cause:

• Immediate pain
• Sudden weakness
• Inability to lift the arm

Traumatic tears, especially in younger or active patients, are more likely to benefit from early surgical repair.

When Is Rotator Cuff Repair Recommended?

• Degenerative tears with persistent pain / weakness despite physical therapy
• Persistent pain that limits sleep despite therapy
• Acute traumatic tears especially in younger active patients
• Large full-thickness tears and/or those with retraction of the tendon

Many degenerative and partial thickness rotator cuff tears do NOT require surgery and respond well to rest, physical therapy, and PRP injections.

What Happens During Surgery?

Rotator cuff repair is performed arthroscopically (minimally invasive), using several small (1cm) incisions around the shoulder and a camera.

The surgeon will:

1. Clean inflamed and degenerative or unhealthy tissue
2. Prepare the bone to a healthy healing surface
3. Reattach the tendon with sutures and anchors
4. Address other issues if needed (biceps tendon, labrum, AC joint arthritis, etc)

The goal is to restore the tendon to its normal position so it can heal to the bone.

Recovery and Rehabilitation After Rotator Cuff Repair

Immediately After Surgery (Weeks 0–6)

• Your arm will be in a sling for6 weeks to protect the repair.
• You may move your wrist, hand, and elbow right away.
• No active shoulder motion.
• Passive shoulder stretching directed by your therapist.

Your shoulder will feel stiff and weak at first—this is normal.

Early Therapy Phase (Weeks 6–12)

Once the tendon has begun to heal:

• The sling is removed.
• Physical therapy focuses on:
  • Restoring range of motion
  • Gentle assisted stretching
  • Preventing stiffness
• Stillno heavy lifting or strengthening

Strengthening Phase (Months 3–6)

When motion improves and the tendon is strong enough:

• Light strengthening exercises begin
• Progressive strengthening as guided by your physical therapist

Still avoid heavy lifting or overhead resistance.

Return to Full Activity (Months 6–12)

Most patients continue to recover from 6–12 months.

• Goal to return to all desired activities
• Progression to overhead weight exercises as tolerated and desired
• Progression to overhead sports (e.g. swimming, tennis)

Summary

Rotator cuff repair is a reliable procedure that restores shoulder strength, reduces pain, and improves function in patients with significant tendon tears. Whether caused by degeneration or trauma, a carefully planned repair and a committed rehabilitation program give most patients excellent long-term results.

With patience, consistency, and guidance from your care team, you can expect a steady recovery and a return to the activities you enjoy.

I hope this provides some useful information regarding the procedure and recovery. Please never hesitate to schedule a consultation with Dr. Huff if you think you may benefit from this procedure.

Best,

Scott Huff, MD