Post-Rotator Cuff Surgery Rehabilitation: Addressing Pain and Recovery Concerns

Rehabilitation after rotator cuff arthroscopy?

Hello Dr.
Chen,
My mother underwent arthroscopic surgery to repair a torn rotator cuff in January of this year.
During her follow-up appointment two weeks ago, the doctor mentioned that she could start rehabilitation.
However, my mother has been experiencing pain from her shoulder to her upper arm, and she believes it is due to inflammation and insists on resting instead of participating in rehabilitation.
Is this perspective correct? Since I was unable to attend the follow-up appointment, I am unsure whether it is better to avoid rehabilitation when experiencing pain in the upper arm and shoulder, or if she should continue with rehabilitation regardless of the pain.
Additionally, my mother has been saying that her upper arm and shoulder hurt, which is why she wants to continue wearing the brace she was given after surgery.
Is this the right approach? It has already been a month since she started wearing it, and the doctor has indicated that she can begin rehabilitation.
I am confused about whether she should keep wearing the brace or if she should stop using it despite the pain.
Lastly, I would like to know how long it typically takes to recover from this surgery and when she will be able to lift heavy objects, such as a 2-kilogram water bucket.

Thank you, Dr.
Chen, for addressing these concerns.

A, 20~29 year old female. Ask Date: 2022/02/23

Dr. Chen Bochen reply Orthopedics

Hello, postoperative rehabilitation is a highly individualized treatment and is not the same for everyone.
The standard approach is to follow the instructions of the surgeon who performed the operation on your mother.
If your mother is afraid of pain, she should be referred to a rehabilitation specialist who can assist with her recovery.
Otherwise, delaying rehabilitation can lead to adhesions, which can significantly impact her recovery in the future.
Wishing her a speedy recovery.

Reply Date: 2022/02/23

More Info

Post-rotator cuff surgery rehabilitation is a critical phase in the recovery process, and it is understandable that your mother is experiencing pain and discomfort in her shoulder and upper arm. After a rotator cuff repair, it is common for patients to experience pain, which can be attributed to inflammation, surgical trauma, or the healing process itself. However, it is essential to balance rest with rehabilitation exercises to ensure optimal recovery.

Firstly, it is important to recognize that while pain is a natural part of the healing process, completely avoiding rehabilitation due to discomfort is not advisable. Engaging in physical therapy is crucial for regaining strength, mobility, and function in the shoulder. The rehabilitation process typically begins with gentle range-of-motion exercises, which can help alleviate stiffness and promote healing. If your mother is experiencing significant pain, it may be beneficial to communicate this to her physical therapist, who can adjust the rehabilitation program accordingly. They may incorporate modalities such as ice, heat, or electrical stimulation to manage pain and inflammation before progressing to more active rehabilitation.

Regarding the use of a shoulder brace or sling, it is generally recommended to wear it for a specified period post-surgery, usually around four to six weeks, depending on the surgeon's protocol and the extent of the repair. If the surgeon has cleared her for rehabilitation, it may be time to gradually reduce the use of the brace, as prolonged immobilization can lead to stiffness and weakness. However, if she feels more comfortable wearing the brace due to pain, it is essential to discuss this with her healthcare provider. They can provide guidance on how to transition out of the brace while ensuring that she does not compromise her recovery.

As for the timeline for recovery, it varies significantly among individuals. Generally, patients can expect to see improvements in pain and function within a few weeks to months following surgery. Full recovery, including the ability to lift weights such as a 2-kilogram water bucket, can take anywhere from three to six months, depending on the individual's healing process, adherence to rehabilitation, and the complexity of the surgery. It is crucial to follow the surgeon's and physical therapist's recommendations regarding activity levels and weight-bearing restrictions.

In summary, while pain is a common experience post-rotator cuff surgery, it is essential for your mother to engage in rehabilitation to promote healing and regain function. Open communication with her healthcare team about her pain levels and concerns will help tailor her recovery plan. Gradually reducing the use of her brace, as advised by her surgeon, and following a structured rehabilitation program will facilitate her recovery and help her return to her daily activities, including lifting light weights. Encourage her to stay positive and committed to her rehabilitation, as this will significantly impact her overall recovery outcome.

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