In order to regain proper use of the shoulder after a full tear of the rotator cuff, surgery is the only option. After surgery, physical therapy is the ideal way to heal properly in order to regain full use of the shoulder. However, Physical therapy is not performed until the patient receives permission from the physician stating that the sling (worn to protect the shoulder and arm after surgery) may be removed.
In order for the shoulder to have full functionality and mobility after surgery, the patient needs to attend physical therapy sessions on a regular basis. In the beginning, the activities chosen by the physical therapist are very simple. As physical therapy continues, and the patient regains mobility in the shoulder area, the exercises become more rigorous. Each patient is different, and because of this the physical therapist will evaluate the patient in the beginning to ensure proper exercises given.
The first few weeks after the surgery is when the shoulder is very tender and can be reinjured very easily. The sling is worn to protect the shoulder area and must be worn at all times with the exception of bathing and dressing. Once the sling can be taken off, physical therapy will begin, very gradually, to help the shoulder move properly once again. There are many different range-of-motion exercises that the physical therapist will do with you; manual therapy may also be formed at this time to alleviate any pain. In addition to this, icing and stimulation by electrical current can also relieve the pain.
As the therapy sessions increase over time, the strengthening exercises may become a challenge for the patient. The physical therapist will help the patient perform the exercises and begin to work through the pain without over doing it. In addition to the physical therapy sessions, the patient will begin to use his arm more often throughout the day; however, there will be limits placed on what the patient can and cannot do with the arm (such as heavy lifting).
Strengthening the main muscles of the trunk area, the shoulder blade, and of course the rotator cuff muscles are the goals of the physical therapist. Performing exercises to strengthen these muscles will help the patient over time develop a normal range of motion and mobility in the shoulder area. With these activities, the patient will slowly be able to perform normal everyday tasks with the shoulder and arm, but it will take time. It is a gradual process and the client must be patient with the process so another injury to the rotator cuff does not occur. Full mobility will eventually come again, and the patient will be able to live a life without shoulder pain.