For all those following along with my journey, I have moved just past the 8 week post-op mark. I am pleased to report that I continue to see small steady improvements with my mobility during day-to-day activities as long as I am moving below shoulder height. I continue to have periodic and general low-level soreness at times (intermittent) but no marked pain unless really pushing my motion with stretching.

MD Follow-up

I recently saw the surgeon between weeks 6 and 7. He examined the shoulder and determined everything seemed to be progressing fine. I explained to him that I felt my passive range of motion (particularly flexion) felt limited by a pinching pain along the front of the shoulder in PT and at home. I also just felt that the shoulder was more stiff than I had hoped it would be at this point. He recommended giving me a steroid injection to help with inflammation and mobility. He assured me it would in no way compromise the repair.

See the article abstract below regarding early AROM after surgery:

https://pubmed.ncbi.nlm.nih.gov/31084488/

This was my first experience with cortisone. Patients have always told me 1 of 3 things:

  1. It’s magic and now all the pain is gone
  2. It hurts more initially but eventually after a few days they noticed some relief
  3. It did NOT help at all

The response for me was more in line with answer #2. The posterior shoulder was very sore within 2-3 hours after the injection, and the shoulder felt very heavy the rest of the day (motion actually seemed worse). In 24-36 hours, that pain and heaviness subsided, and I would say I could move the shoulder somewhat better in 72 hours. Since the injection, I have not had the pinching pain, and the motion seems to be getting better gradually. With that said, I still have some discomfort at times and a long way to go to recover all my motion as expected at this phase of the rehab process.

Rehab update

At the 8 week post-op mark, my ROM measurements were:

AROM: Flexion Р120 degrees, Abduction Р90 degrees, ER Р40 degrees

PROM: Flexion – 128 degrees, ER – 45 degrees, IR – 45 degrees

I have begin to work on lifting my arm more, albeit with the notorious “shrug sign” as my upper trap is overly active and my cuff still very weak. There is some debate and even controversy about how early we should move the shoulder actively after rotator cuff surgery. I refrained for the first 6 weeks, opting for passive and light active assistive motion only. There is a new meta-analysis that was just published in the JOSPT journal looking at this topic and its impact on ROM and the integrity of the repair itself. Click on the link below to check it out:

https://pubmed.ncbi.nlm.nih.gov/33998264/

I have continued going to PT 2x/week and doing my exercises twice per day on the off days at home. Oddly enough, the shoulder is still sensitive to exercise volume and too much movement. I have had to back off the amount of daily walking too, as I feel as though the repetitive arm swing and faster cadence was irritating the shoulder especially when eclipsing the 3 mile mark.

I have been using the pulley, doing my cane exercises, and began some light scapular strengthening including serratus punches, prone row and prone extension (no weight), and gentle rhythmic stabilization work with the PT. I have continued gentle biceps/triceps work (elbow at my side) as well as doing theraband walkouts for IR/ER strengthening. I am turning the corner with basic activities of daily living and able to do most things below shoulder height when it comes to dressing, bathing, household chores, etc. I have avoided any heavy lifting of course.

Next steps

I return to the doctor on August 4th to assess my progress and set a return to work date. I am hopeful I can resume work around the 3 month post-op mark with some mild limitations, namely avoiding heavy pushing/pulling and lifting with long levers. I plan to continue therapy 2x/week until I head back to the office as well, while tweaking the frequency, intensity and volume of my home program based on how my shoulder feels.

Clinical pearls

  • I am NOT superman after all (LOL) and one cannot cheat mother nature in this healing process despite all the knowledge and experience in the world
  • It is 100% okay to give yourself permission to be sad, angry or frustrated at any given point in time during the recovery, BUT maintain sight of the end goal and understand that small intentional steps along the way will get you there so keep moving and working within your tolerance each day
  • Do NOT spend time comparing yourself to others who have had this surgery. Everyone responds to surgery differently, and your healing process may progress faster or slower based on age, severity of the tear, activity level, work demands, etc.

I hope these posts prove useful for those going through the same process or caring for loved ones/friends with rotator cuff repairs. As always, feel free to comment or ask any questions.