Large Rotator Cuff Repair – Stage 1 Physiotherapy Advice and Exercise

This leaflet informs you about stage 1 post-operative exercises and advice following a large rotator cuff repair.

Before you are discharged, a member of the inpatient therapy team will guide you through the exercises. They will provide you with advice and answer any questions you may have.

What can I do to help myself?

It is very important to get as much movement back in your shoulder as soon as you can. This will mean you can start to use your shoulder and perform your daily functions. Managing your pain and doing your exercises every day will help this to happen quicker.

If you require it, pain relief can be very useful to help minimise any pain and to give you the confidence to exercise and use your shoulder.

If you have been given pain relief, you should take it as prescribed. You should always read the label if using over-the-counter medication and, if you are in any doubt, speak to your pharmacist or GP. If your pain becomes severe or is continuous, you should contact your GP.

What exercises should I do after my surgery?

Once the nerve block has fully worn off and you have feeling back in your arm, you may start your home exercise programme. This usually takes between 12 to 48 hours.

You should aim to perform the following exercises 3 times a day. Perform 10 repetitions, have a rest for 1 minute and repeat a further 10 times.

During your operation, your surgeon will decide on a range of movements that you can move your shoulder in without causing any significant stress on the surgical repair. This is called the safe zone.

The safe zone is there to give you the confidence to perform your exercises. The inpatient therapy team will educate you on what your safe zone is and your outpatient physiotherapist will progress and guide your future recovery.

It is normal for you to feel aching, discomfort, or stretching feelings when doing these exercises. If you experience intense and lasting pain (e.g. longer than 30 minutes), do the exercises less forcefully or less often. If this does not help discuss the problem with the Physiotherapist.

Exercise 1: Seated Table Slides

While sitting, rest your hands on a table. Using a duster or similar object, lean forwards and slide your hands away from your body to as far as comfortable and then return to the start position.

Exercise 2: Shoulder Short Lever Active-Assisted Flexion

Lying on your back with your knees bent and feet flat on the bed. Support your operated arm underneath your elbow with your unaffected hand.

Using help from your unaffected arm, slowly lift your operated arm up and away from your chest. Stop at the recommended height from your surgeon (Safe zone). Return to the start position.

Note: You can perform the exercise lying on your back as indicated in the above images or while seated. Find which position is most comfortable for you.

Exercise 3: Shoulder Active-Assisted External Rotation

Image 1 Image 2

Start with your hand on your tummy, bend your elbow to 90 degrees, as shown it the Image 1 and 2. Tuck your elbow in by your side with a rolled towel in between your upper arm and body.

Holding a stick or similar object, keeping your elbows in at your side, use your unaffected arm to push the stick outwards to rotate your operated arm through your safe zone. Return to the start position.

Note: You may find it more comfortable to support your arm on a pillow. Some people find this more comfortable to do lying down (Image 2). Find which position is most comfortable for you.

Contact Numbers

If you need further advice, or have any problems, please contact the appropriate number below:

North Tees & Hartlepool NHS Foundation Trust

Upper Limb Secretary

Telephone: 01642 624442

Monday to Friday, 9.00am to 5.00pm

Physiotherapy Appointment Queries

Telephone: 01429 522471

Monday to Friday, 9.00am to 5.00pm

Ward 32/33

Telephone 01642 382832 or 01642 382732

24 hours 7 days a week

Leven Unit:

Telephone 01642 383832

Monday to Thursday, 7.00am to 8.00pm

Fridays, 7.00am to 7.00pm

Other Useful Links

Website: North Tees and Hartlepool NHS Foundation Trust

Upper Limb (Shoulder, elbow, hand and wrist surgery) – patient information. https://www.nth.nhs.uk/services/trauma-orthopaedics/upper-limb/

References

• Hachard. N.C.A., Goodchild, L., Brealey, S.D., Lamb, S.S and Rangan, A. (2020). Physiotherapy for primary frozen shoulder in secondary care: developing and implementing stand-alone and post operative protocols for UK FROST and inferences for wider practice. Physiotherapy. [Online] 107, PP. 150 -160.
• Pictures supplied by Physio tec. Accessible at: https://physiotec.ca/ca/en/

Patient Experience Team (PET)

North Tees and Hartlepool NHS Foundation Trust would like your feedback. If you would like to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Team who will help you to do this.

This service is based at the University Hospital of North Tees but also covers The University Hospital of Hartlepool, our community hospitals and community health services.

North Tees and Hartlepool NHS Foundation Trust
Telephone: 01642 624719
Freephone: 0800 092 0084
Email: [email protected]
Monday to Friday, 9:30 am to 4:00 pm

Out of Hours
If you wish to speak to a senior member of Trust staff, please contact the hospital switchboard (numbers below).