Rotator Cuff Repair
What Is Rotator Cuff Surgery?
Rotator cuff surgery, also called rotator cuff repair, reattaches a torn rotator cuff tendon back to its normal position on the humerus. Since a fully torn rotator cuff tendon cannot heal on its own once separated from the bone, surgery is aimed at restoring this connection so the tendon can heal back into place and regain its role in shoulder strength and motion.
When Is Rotator Cuff Surgery Needed?
Rotator cuff surgery is generally considered for:
- Full-thickness tears, particularly in younger or more active patients
- Acute, traumatic tears, since these tend to do better with earlier repair rather than delaying treatment
- Tears causing significant pain or weakness that hasn’t responded to a course of physical therapy and other nonsurgical treatment
- Progressive tears that continue to enlarge over time, since larger, more chronic tears generally become more difficult to repair successfully
How Is Rotator Cuff Surgery Performed?
Most rotator cuff repairs today are performed arthroscopically, through small incisions using a camera and specialized instruments. The torn tendon edges are identified and mobilized, and small suture anchors are placed into the bone at the tendon’s normal attachment site. Sutures passed through these anchors are then used to pull the torn tendon back down to the bone and hold it securely in place while it heals. The specific repair pattern used depends on the size, shape, and location of the tear, and larger or more complex tears may require additional techniques to achieve a secure repair.
Recovery After Rotator Cuff Surgery
Rotator cuff repair requires one of the more patient, structured recovery processes among shoulder surgeries, since the repaired tendon needs significant time to biologically heal back to the bone before it can tolerate normal use:
- A sling is typically worn for approximately 4 to 6 weeks to protect the repair, even though the shoulder may feel capable of more movement sooner
- Passive range-of-motion exercises (where the therapist or the opposite arm moves the shoulder, rather than the repaired muscles doing the work) are introduced early, while active use of the arm is delayed until the tendon has had adequate time to heal
- Active strengthening is introduced gradually, typically starting around 6 to 12 weeks after surgery
- Full recovery, including return to overhead sports or heavy lifting, generally takes 6 months or more, reflecting the biological reality of how long it takes tendon to firmly heal to bone
Following the prescribed sling and activity restrictions closely in the early weeks — even when the shoulder feels better than expected — is one of the most important factors in a successful long-term outcome.
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How Long Does a Rotator Cuff Repair Last?
Once a repaired rotator cuff tendon has fully healed, it typically does not tear again in the same location. That said, returning to repetitive overhead lifting or overhead sports does place ongoing stress on the shoulder, which can lead to tendonitis or, over time, a new tear if the shoulder isn’t maintained. Patients who stay consistent with some level of ongoing shoulder strengthening exercises generally protect their repair for the long term — most patients report lasting satisfaction with their rotator cuff repair even 10 or more years after surgery.
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Dr. Palsis specializes in the treatment of knee, shoulder, and sports injuries.