Pain Level After Rotator Cuff Surgery

Pain Level After Rotator Cuff Surgery

The rotator cuffs are a group of four tendons surrounding the shoulder joint. These tendons attach the upper arm’s muscles to the upper arm bone (humerus). They also work together to stabilize and enable the full range of motion of the shoulder joint. Due to their constant movement in our everyday lives, they are susceptible to injury due to overuse, trauma, or wear and tear from natural aging. 

Options for treatment after a rotator cuff injury include medication such as NSAIDS, rest, ultrasound therapy, physical therapy, and surgery. 

A rotator cuff surgery helps to repair damage to the rotator cuff tendons in the shoulder. It is a procedure that relieves pain and restores functionality in the shoulders. As with any surgical procedure, you may experience pain after rotator cuff surgery. While the degree of pain may differ, it can hinder you from carrying out your daily activities comfortably. What can you do? Read on to find out.

What is Rotator Cuff Surgery?

Rotator cuff surgery is one of the methods used to fix a damaged rotator cuff. It is often necessary when other non-surgical methods have failed to fix the injury.

There are different approaches to repairing a damaged rotator cuff. Sometimes, this determines the level of postoperative pain an individual may experience. The arthroscopic and open surgery methods are the most common methods to perform rotator cuff surgery. 

Arthroscopic repair is a minimally invasive method of performing rotator cuff surgery. It involves passing a tiny camera through a small incision into the shoulder joint to use miniature surgical instruments to repair damaged tissues. The small camera displays a live feed on the monitor, which guides the surgeon’s actions. People who undergo arthroscopic rotator cuff surgery experience less postoperative pain and recover faster than other surgical methods.

Open repair, on the other hand, is the traditional surgical method. It involves a large incision of several centimeters to access the shoulder joint. This method is necessary if the tear in the rotator cuff is extreme and the surgeon needs to see the damaged area better. However, a patient who undergoes open rotator cuff surgery needs more time to recuperate and may experience more pain.

Postoperative pain refers to the pain a person experiences after a surgical procedure. There are precautions people can take after surgery to prevent complications and manage pain. One of the most popular and successful methods of controlling postoperative pain is physical therapy. This article will examine the methods used to treat and relieve the pain felt after rotator cuff surgery at Barkman & Smith Physical Therapy.

Factors that Affect Pain Level After Rotator Cuff Surgery

Several factors can affect your pain level after rotator cuff surgery. Some of these include:

Tear Size and Location

The size and location of the rotator cuff tear play a significant role in your pain levels after rotator cuff surgery. Little rotator cuff injuries, in general, are more easily treatable surgically. On the other hand, more extensive tears in the rotator cuff take longer to repair and heal from.

The Surgical Technique

The choice of surgical method impacts an individual’s pain levels after rotator cuff surgery. While individuals who undergo arthroscopic rotator cuff surgery may experience low levels of pain, individuals who undergo open rotator cuff surgery experience more pain.

Surgical Complications

Despite the improvement and increase in the safety of surgical procedures, complications may still arise during or after surgery. Infection or nerve damage during surgery, however rare, may worsen the pain levels of an individual after rotator cuff surgery.

Pre-surgical Care

Pre-surgical physical therapy in Bedford helps to enhance surgical outcomes and ensure better pain management. Individuals who undergo prehabilitation in Bedford, TX, may experience lower pain levels after rotator cuff surgery. 

Individual Differences

Pain thresholds differ from person to person. Therefore, the pain an individual feels after rotator cuff surgery might be mild compared to that of another patient.
Age, patient health, muscle weakness, immobilization, inflammation, and other medical conditions are other factors that affect the pain levels of individuals after rotator cuff surgery.

Managing Pain After Rotator Cuff Surgery

It is essential to undergo proper pain management after rotator cuff surgery to ensure a quick recovery. Post-operative rehabilitation helps to recover the shoulder's strength, range of motion, and function. Several treatment methods help to manage and relieve pain after rotator cuff surgery. These include physical therapy, medication, ice therapy, elevation, etc.

Physical Therapy

Physical therapy is essential in the recovery process after rotator cuff surgery. This treatment method manages and reduces pain levels while restoring function and mobility in the shoulder. There are three main phases with different stages involved in shoulder pain therapy in Bedford, TX:

Early Post-operative Care

This phase typically begins a few days or weeks after the rotator cuff surgery. The sole aim of early post-operative care is reducing inflammation, relieving pain, and protecting the repaired tissues. Stages of early post-operative care include:

1. Passive Range of Motion Exercises: Passive range of motion exercises help you maintain shoulder mobility without putting a strain on your healing shoulder tissues. They are simple exercises involving the movement of the shoulder joint in all directions possible to prevent stiffness. 

2. Pain Management Techniques: While pain is a natural part of the healing process, managing it is essential to prevent complications and return to normal function. Physical therapists may employ other modalities to reduce inflammation and relieve pain and discomfort. Some modalities include gentle manual therapy, ultrasound, hot and cold therapy, etc.

In the initial part of the early post-operative care, you might have to wear a sling to immobilize your arm and protect your repaired tendons. However, you may gradually lose the sling to promote joint mobility.

Intermediate Rehabilitation

Intermediate rehabilitation is the second phase of physical therapy after rotator cuff surgery. It begins about 6 to 12 weeks after surgery. At this stage, shoulder mobility and strength start to improve. The steps involved in this phase include:

1. Active Range of Motion Exercises: Active range of motion exercises improve the flexibility of your shoulder and prevent it from becoming stiff. They are agile motion exercises demanding you to move your shoulder actively without assistance.

2. Other Exercises: At the intermediate rehabilitation phase, your physical therapist may introduce other exercises to ensure you recover faster. These activities include strengthening exercises, proprioception training, scapular stabilization, etc.

While carrying out the recommended activities in this phase, you must be cautious to avoid overexertion and reduce the risk of further injury.

Advanced Rehabilitation

This phase is the last phase of physical therapy after rotator cuff surgery. It typically starts about 3 to 4 months after surgery, and its goal is to restore full strength, endurance, and function in the shoulder. The stages in the advanced rehabilitation stage include:

1. Functional Training: Your physical therapist may curate more tedious exercise programs to prepare you for a return to your normal activities.

2. Progressive muscle strengthening exercises: Lack of muscle activity leads to muscle atrophy (the thinning of muscle mass). Strengthening exercises help to rebuild muscle mass and shoulder strength. 

Other components of physical therapy after physical therapy include:

  • Management of Scar Tissues: Scar tissues may form at the incision site after surgery, limiting shoulder mobility. Physical therapists use techniques like scar massage and stretching to reduce its impact on shoulder function and relieve pain.
  • Education and Home Exercises: In addition to therapy, physical therapists also provide education to their patients on the proper shoulder mechanics. They also recommend home exercises that complement the rehabilitation program outside the regular therapy sessions.
  • Posture and body mechanics: Wrong posture or body mechanics can strain the shoulder joint, putting you at risk of re-tear and chronic pain. Physical therapists try to prevent this by ensuring their patients maintain the proper posture and body mechanics every time.

Benefits of Physical Therapy after Rotator Cuff Surgery

The following are the benefits of undergoing physical therapy after rotator cuff surgery:

  • Pain relief: This is the foremost benefit of physical therapy after rotator cuff surgery. The therapeutic techniques and exercises of physical therapy manage postoperative pain effectively.
  • Faster recovery: Physical therapy after rotator cuff surgery is a form of postoperative rehabilitation. It can quicken your healing process and get you back to your normal activities in no time.
  • Improved range of motion: Physical therapy restores and maintains shoulder flexibility. This improvement in your shoulder’s range of motion allows you to go about your daily activities comfortably.
  • Prevention of future injuries: Physical therapy after rotator cuff surgery can ensure you do not experience re-tear and future shoulder problems.


Pain after rotator cuff surgery is normal and almost inevitable. However, it may interfere with your daily activities and affect your quality of life. Therefore, it is essential to manage your pain effectively to promote healing and avoid complications. Physical therapy is a treatment method that can help manage postoperative pain effectively while restoring shoulder function, range of motion, and mobility. If you are experiencing unbearable pain and discomfort after your rotator cuff surgery, seek physical therapy at Barkman and Smith Physical Therapy.