What it is

Rotator cuff repair reconnects a torn tendon to its bone attachment. Repairs may be arthroscopic or mini-open. The aim is to restore a stable tendon-bone interface and rebuild strength and control for daily use and sport.

Rehabilitation protects the repair early, then progressively loads the tendon. Timelines vary with tear size and tissue quality.

What happens when it occurs

Sutures and anchors secure the tendon to the bone. Healing requires weeks of protection from strong contraction. The plan transitions from a passive range to active motion and then to strengthening. Daily function returns in stages.

Common causes and risk factors

  • Traumatic lift or catch in adults over forty
  • Degenerative tendon changes with repetitive overhead work
  • Smoking and metabolic health factors
  • Previous shoulder symptoms or stiffness

Who is most affected

Adults over forty and manual workers. Overhead athletes and carers also feature.

Typical symptoms pre op

  • Night pain and difficulty lying on the shoulder
  • Weakness and a painful arc when lifting
  • Loss of power in overhead tasks

When to seek care

After a sudden loss of strength or when night pain persists despite rest and rehabilitation.

How we diagnose

History and examination with strength deficits and cuff tests. Ultrasound or MRI confirms pattern, size, and retraction. Findings guide repair and postoperative precautions.

Management

  • Sling protection with staged range progression
  • Pain control and swelling management
  • Scapular control and deltoid activation early
  • Rotator cuff strengthening in protected arcs, then full range
  • Work and sport integration with criteria-based testing

Rehabilitation milestones

Phase 1 weeks 0 to 6: sling, passive range in safe arcs, elbow and hand work, scapular set.

Phase 2 weeks 6 to 12: active assisted to active range, light isometrics, posture and thoracic mobility.

Phase 3 months 3 to 6: progressive cuff and scapular strength, functional reach, work drills.

Phase 4 months 6 to 9: overhead strength, plyometric and power work where required, return to sport testing.

Readiness to progress

  • Pain is stable across a week
  • Active elevation improving without shrug
  • Strength and endurance within 80 to 90 per cent, then sport-specific tests

Long-term care

  • Keep the cuff and scapula strong year-round
  • Plan deloads and avoid sudden spikes in overhead volume
  • Maintain thoracic mobility and posture habits

Australia snapshot

  • Standard procedure in public and private hospitals
  • Men present more often than women in traumatic tears
  • Day surgery pathways and imaging-guided diagnosis are widely available

Latest insights

Protection first, then progressive loading. Strength at long muscle lengths matters.

Function, not images alone, clears the path to work and sport.

Frequently Asked Questions

Commonly four to six weeks, depending on tear size and surgeon protocol.

When you are out of the sling, have comfortable control, and can react safely. Confirm with your team and insurer.

Risk decreases with protection and a well-dosed programme. Tissue quality and tear size influence risk.

Usually, after the sling wean and once pain allows. Use pillows for support.

Often, after three to six months, when strength and function meet the criteria.

Progress is judged on function and symptoms. Imaging is used selectively.