Rotator cuff surgery: preparing for surgery and recovery

Preparing for rotator cuff surgery can help you know what to expect before your procedure and during recovery. This guide explains how to prepare for surgery, care for your shoulder afterward and safely progress through recovery.

Before your surgery

Depending on where your surgery is performed, you may need testing before your procedure. This is called preoperative testing, and may include blood work, an EKG (a test that checks your heart) or a chest X-ray.

If testing is needed, it will be scheduled for you as part of your preoperative visit with the anesthesia team. If you have several medical conditions or have not seen your primary care doctor recently, you may also be asked to see them before surgery.

The night before surgery

Do not eat or drink after midnight the night before surgery. You may be told to take certain medications with a small sip of water. Your anesthesia team will give you specific instructions about which medications you should take.

Arriving for surgery

Plan to arrive about two hours before your scheduled surgery time. It is important to arrive on time, even though your surgery may occasionally be delayed if an earlier procedure takes longer than expected.

What to expect before rotator cuff surgery

After you check in, a nurse will review your medical information and start an IV. You will also meet with a member of the anesthesia team to discuss your anesthesia and any questions or concerns.

Rotator cuff surgery is performed under general anesthesia, which means you will be asleep during the procedure. Your anesthesiologist may also recommend a regional nerve block to help control pain after surgery. A nerve block uses numbing medicine near the nerves that provide feeling to your shoulder and arm. Your anesthesiologist will discuss the benefits and risks with you.

During surgery

Rotator cuff surgery usually takes about 1.5 to 2.5 hours, although this varies from case to case. Your belongings will be stored in a locker in the preoperative area. Family members or caregivers can wait for you in the waiting room. Your surgeon will speak with them after the procedure.

After surgery

After surgery, you will recover in a postoperative recovery room. Once you are stable and comfortable, family members or caregivers will be invited to sit with you while you continue recovering from surgery. Your shoulder will have a dressing, and your arm will be supported in a sling. Before you can go home, your pain should be under control and you should be able to eat, drink and walk to the bathroom with little assistance.

Caring for yourself after rotator cuff surgery

How long will I wear my sling after rotator cuff surgery?

After surgery, your shoulder will be placed in a sling as directed by your doctor. Your sling protects your shoulder and limits movement while the repaired tendon heals. Some patients may need a sling with a pillow that is attached around your waist for extra support.

Always follow your surgeon’s instructions for how and when to wear your sling.

• The sling is typically used for 4 to 6 weeks after surgery.
• Do not reach, lift, push or pull with your surgical arm.
• Do not reach behind your back with your surgical arm.
• You may remove your arm from the sling several times a day to bend and straighten your elbow and move your fingers.
• You may remove your sling to bathe, dress and perform elbow range of motion exercises as directed.

Watch the video below to see how you should properly wear your sling:

Eating after rotator cuff surgery

Eat a light diet the evening of surgery and the following day. You can return to your regular diet when you feel ready.

Managing your pain after rotator cuff surgery

You will receive instructions for managing your pain after surgery. If you are prescribed pain medicine, take it only as directed.

Using ice after rotator cuff surgery

Ice can help reduce pain and swelling after surgery. A cold therapy machine is available for purchase, or you may use an ice pack or bag of frozen vegetables.

• Use ice on your shoulder for the first 48 to 72 hours after surgery.
• During the first week, ice your shoulder two to three times a day, especially before going to sleep.
• Place a T-shirt or thin towel between your skin and the ice or cold therapy sleeve to protect your skin.

Caring for your surgical incision

• If you do not have a pain catheter, you may remove your dressing and shower 48 hours after surgery.
• If you had a biceps tenodesis performed, leave your dressing on for five days after surgery.
• If you have a pain catheter, a family member should remove it 72 hours after surgery along with the shoulder dressing before showering.
• Do not soak your incisions in a bathtub or pool for six weeks.
• You may shower and allow water to run over your incisions. Afterwards, pat them dry and cover them with Band-Aids. Do not apply ointment over the incisions.
• Call your care team if you notice drainage, swelling or increased pain five days after surgery.
• Redness around the incision is very common and should not be a concern. However, please call our office if you have:
  • Redness and drainage five days after surgery.
  • Redness spreading away from the incision.
  • Redness and a fever.

Sleeping after rotator cuff surgery

Sleeping can be difficult during the first week or two after rotator cuff surgery, as surgery can interfere with your sleep-wake cycle. You may also have more shoulder pain when lying flat on your back. You may be more comfortable sleeping in a recliner or in a reclined position in bed. Try placing a pillow between your arm and body and another pillow behind your elbow for support. Wear your sling while you sleep.

Driving after rotator cuff surgery

If you had a rotator cuff repair, wait until at least your first postoperative visit before driving. You need to be able to safely control your vehicle with limited use of your surgical arm. Do not drive while taking narcotic pain medication.

How long does recovery take after rotator cuff surgery?

Recovery after rotator cuff surgery usually takes several months, as rotator cuff tendons heal slowly. It typically takes about three months for the tendon to heal, followed by another two to three months to regain shoulder strength. Recovery may take longer depending on the size of your tear and how well the tendon heals.

The goal of surgery is to reduce pain and improve shoulder function. Results can vary based on factors such as your age and the size of your tear. Larger tears and tears in older patients may be less likely to fully heal, and some shoulder weakness may remain. In general, about 90% of patients are satisfied with their shoulders after rotator cuff repair and have significant improvements in pain and function after surgery.

Physical therapy

Physical therapy and exercise are different for every patient. Your surgeon will discuss this with you on your first postoperative visit.

Some patients may be instructed to begin gentle range-of-motion exercises as early as the day of surgery. Your care team will show you how to do these exercises on your own. Your surgeon or care team will provide instructions based on your repair. Risks of rotator cuff surgery As with any surgery, rotator cuff surgery has possible risks and complications. The list below includes some, but not all, of these risks. Fortunately, complications are very rare.

Complications may include:

• Problems related to anesthesia
• Infection (very rare with arthroscopic procedures)
• Nerve or blood vessel injury (extremely rare)
• Bleeding (extremely rare)
• Shoulder stiffness
• Failure of the tendon to fully heal to the bone
• Problems with anchors or sutures used during repair
• Continued pain, weakness or other symptoms
• Blood clots
• Complex regional pain syndrome, a condition that causes ongoing arm pain
  

When to call your surgeon

Call your surgeon immediately if you have:

• Increasing redness or swelling around your incision
• Significant drainage from your incision
• A fever higher than 101.5˚
• Trouble eating or drinking after surgery
• Difficulty breathing

Rarely, temporary breathing problems can occur after a regional nerve block or pain catheter. For emergency calls during normal business hours, please call (314) 514-3500. After 4:30 p.m., please call the after-hours exchange at (314) 388-5550.

To contact your physician for a nonurgent question, please call your physician’s nurse or medical assistant with the contact information provided to you during your office visit.

Rotator cuff surgery patient guide

For more detailed information about preparing for surgery, view our rotator cuff surgery patient guide (PDF). It includes helpful checklists, tips for getting your home ready, medications to avoid before surgery and other important instructions.

Get expert care for your shoulder

Whether you're considering surgery for a rotator cuff injury or preparing for your procedure, our WashU Medicine shoulder and elbow specialists are here to help. Our team provides personalized treatment and guidance to help you get back to the activities you enjoy.