Rotator cuff surgery takes about an hour. Recovery takes six months to a YEAR.
For the first six weeks your job is NOT to use the arm. The repair is at its weakest just when you start feeling ready to test it. Most people feel genuinely good somewhere around six months, and some take a full year.
Bigger tears move slower. Your surgeon’s instructions beat any timeline on the internet, including this one.
Week by week
- Weeks 0 to 2: sling on all the time, with a small cushion between your arm and body. Move your elbow, wrist and fingers. Shrug and squeeze your shoulder blades. Don’t lift the arm yourself
- Weeks 2 to 6: gentle movement where the arm is moved FOR you, by your physio, your other hand or gravity. Reaching behind your back is off limits. Large tears may wait until week 6 for any shoulder movement
- Weeks 6 to 12: sling off. You start lifting the arm yourself, first with help, then without. It will feel weak and clumsy. That’s six weeks of not using it, not a failed repair
- Weeks 12 to 16: strengthening starts with very light weights
- Months 4 to 6: heavier strengthening, getting ready for work and sport. Lifting overhead comes last
- Months 6 to 12: the final stretch. Most people are about 80 percent better at six months, with some discomfort left for overhead tasks
The repair is weakest exactly when you start feeling ready to test it.
The rules for the first six weeks
- Don’t lift the arm yourself. Your own muscles pull straight on the repair. Your other hand or a physio lifting it doesn’t
- Don’t push up out of a bed or chair with the operated arm. This is the one people break most, usually getting out of bed in the morning
- Don’t carry anything, not even a kettle held close to your body
- Don’t reach behind you. That includes grabbing a seatbelt or putting a hand back to steady yourself
- Ask about painkillers. Some surgeons prefer you avoid anti-inflammatories like ibuprofen for a while. Ask what yours wants
If the subscapularis tendon (at the front of the shoulder) was repaired, you’ll have extra limits on turning the arm outward. Follow your surgeon’s numbers. If a biceps tenodesis was done at the same time, see biceps tenodesis recovery.
Everyday tips nobody mentions
- Take pain relief before the nerve block wears off, not after. Pins and needles as it wears off are normal
- Shower with a waterproof dressing from about day two. Keep the wounds dry until stitches come out at 7 to 10 days
- Wash your armpit by leaning forward and letting the arm hang slightly away from your body
- Dress the operated arm first, undress it last. Loose button-front tops are easiest
- Sleep will be rough for six to eight weeks. See how to sleep after rotator cuff surgery
Will it tear again?
- Somewhere between 1 in 10 and 1 in 2, depending mostly on the tendon you started with
- The biggest risks are things decided before surgery: a large tear, muscle that had already turned fatty, older age and diabetes
- What you control is not breaking the six-week rules
- A stiff shoulder early on is usually a GOOD sign. Stiff shoulders re-tear less often. See stiff shoulder after surgery
When can I…
- Drive: not in the sling and not on strong painkillers. Usually 6 to 8 weeks, once you can do an emergency stop and turn the wheel hard. Start with short trips
- Go back to a desk job: usually 3 to 8 weeks, depending on how you get there
- Go back to manual or overhead work: at least 3 to 4 months, heavy work 4 to 6. About 1 in 3 people never get back to the same level of physical work
- Swim front crawl or play golf: usually from about 3 months
- Play overhead or contact sport: usually 10 to 12 months, once strength is close to the other side
Call your surgeon if
- The wound is red, swollen, weeping or leaking pus
- You feel unwell or have a fever. Infection after this surgery often shows up around 4 weeks, and many people with it have NO fever. Rising shoulder pain matters more than your temperature
- You suddenly can’t lift the arm, but someone else still can lift it for you
- You have new numbness or weakness in the arm or hand
- Severe pain lasts more than about 30 minutes after your exercises, again and again
Six weeks of protecting it, six months of rebuilding it, and a year before you stop thinking about it.