Rotator Cuff Repair - Post Surgery Advice | Singapore General Hospital

Day 0 – 14 (Protection Phase)

Things to take note

Wear a shoulder sling for the first 4 to 6 weeks (according to Doctor’s order)
Take your prescribed pain medications
No carrying of load with operated arm
Place a rolled towel under your shoulder as support when lying down
No active movement of affected shoulder for the first 4-6 weeks
Perform the following exercises 3 times a day, stop if any exercise increases pain and inform your therapist during the next visit.

R.I.C.E. to reduce pain and swelling:

Rest – avoid activities that cause more pain or discomfort.
- Appropriate resting helps to protect injured tissue from further injury and prevents delay in healing.
Ice – apply ice for 15 to 20 minutes, 3 to 5 times a day.
Compress – compression of affected limb. E.g. Bandage, elastic wrap.
Elevate – raise your upper limb at or above the level of your heart with a pillow when lying down to encourage circulation back to the body.

Purpose of exercises

Maintain range and strength of your upper limbs as allowed.
Optimize blood circulation, facilitating wound healing.

Outpatient Physiotherapy will be arranged when the patient is ready to start rehabilitation to regain shoulder movement and strength.

You may be advised to do some of the following exercises by your therapist. Please check with your therapist if you are unsure of how to carry them out.

Exercises (Neck and Upper limb)

Neck Ranging To maintain neck mobility; prevent neck ache from use of sling Relax shoulders Nod head forward & backward, tilt head to the left & right, turn head to the left & right Repeat each exercise 10 times
Scapular Retraction To optimise shoulder blades alignment Relax shoulders Squeeze shoulder blades together. Repeat 10 times, hold 10 seconds.
Elbow Flexion To maintain elbow mobility Relax shoulder. Bend & straighten your elbow Repeat 10 times, hold 10 seconds.
Hand Pumps To maintain optimal blood circulation Clench your fist & open up your fingers repeatedly Repeat 10-20 times hourly
Pendulum To maintain shoulder joint mobility Bend body forward Allow your arm to dangle Relax arm Move your body & legs to generate body momentum to swing the arm for 10-20 times

Post-Surgery: 2 weeks later

Exercises (Neck and Upper limb)

When shoulder range is allowed for repair:

Small tear: Start after week 2
Medium tear: Start after week 3
Large tear: Start after week 4

Confirm with surgeon when ranging of shoulder is allowed to prevent injury to rotator cuff repair

Things to take note:

Continue to wear a shoulder sling
Pain & swelling control:
- Take your prescribed pain medications
- Continue to apply ice to your affected shoulder for 20mins, every 2-3hours
No active movement of the affected shoulder until after 6 to 8 weeks post operation
Perform following exercises 3 times a day – stop if any exercise increases pain and inform your therapist during the next visit

Passive Shoulder Flexion To improve shoulder flexibility Relax your operated arm completely & keep elbow at side of body Grasp it with the unaffected arm & lift it up slowly. Move to max _____degrees Gently lower operated arm down Repeat 10 times, hold 10 seconds
Shoulder External Rotation To improve shoulder joint flexibility In lying position Bend elbows to 900 & position the operated arm on the side of body Using unaffected arm, slowly push the operated arm away using a stick, without shifting your elbows. Avoid pushing more than 400 Gently pull it back in Repeat 10 times, hold 10 seconds
Chair Stretch To promote muscle flexibility around the shoulder joint Stand close to the back of a chair & lightly place your hands on it Walk backwards & stop just before onset of pain Stay in position for 10 counts/seconds Return to starting position Repeat 10 times, hold 10 seconds