To prepare for rotator cuff surgery, set up your home for about 6 weeks of one-handed living, practice putting the sling on and taking it off, and learn the movements your surgeon allows before the day. Arrange rides, since most people cannot drive while in the sling, which is typically worn for about 4 to 6 weeks. Write down your questions for your surgeon now. Your surgeon’s protocol comes first, and timings vary with the size of the repair and with each surgeon.
Most of the hard parts of the first weeks after the repair are practical: getting dressed, sleeping, washing your hair and cooking with one hand. Here I go through what I’d set up and practice before the day.
Key takeaways
- Sling time: plan for about 4 to 6 weeks in a sling, sometimes longer after a large repair.
- Driving: arrange rides; driving is not allowed while in the sling and often returns at 6 to 8 weeks or later.
- Home: move everyday items to between waist and shoulder height on your other side.
- Practice: sling on and off, one-handed dressing, and any movements your surgeon allows before surgery.
- Questions: ask your surgeon about repair size, sling time, movement limits and who to call after hours.
What the operation does
The rotator cuff is a group of four tendons that hold the ball of the shoulder in its socket and help lift and turn the arm. In a repair, the surgeon reattaches the torn rotator cuff tendon to the bone it has pulled away from, using small anchors placed in the bone with stitches attached.
Most repairs are done by keyhole surgery (arthroscopy) through several small cuts. Some use a slightly larger cut. The surgeon may also tidy the space above the tendon (subacromial decompression) or deal with the biceps tendon at the same time.
The stitches hold the tendon in place. The tendon then needs months to grow back onto the bone. That is why the arm is protected for weeks and strengthening waits until around 3 months.
What to set up at home
- Clothing: loose, front-opening shirts a size larger, elastic-waist pants and slip-on shoes. A front-fastening or step-in bra is easier than a back clasp.
- Sleeping position: many people sleep propped up for the first 2 to 6 weeks, in a reclining chair or with firm pillows behind the back. Have a small pillow ready to rest under the forearm.
- Kitchen: move cups, plates and everyday food to the counter or a shelf between waist and shoulder height, on the side of your other arm. Cook and freeze a week or two of meals. Choose containers you can open with one hand.
- Bathroom: pump bottles for shampoo and soap, a long-handled sponge and a non-slip mat. Put toiletries where you can reach them without lifting the operated arm.
- Driving and errands: arrange rides to the hospital, to physical therapy and for shopping for at least 6 to 8 weeks.
- Work: talk to your employer about time off and one-handed or lighter duties.
What to practice before surgery
- Sling on and off: ask for the sling at your pre-surgery visit, or for instructions, and practice with a helper.
- One-handed tasks: dress the operated arm first and undress it last. Practice brushing teeth, eating and toilet hygiene with your other hand, especially if surgery is on your dominant side.
- Gentle movements your surgeon allows: keeping the shoulder as mobile as it comfortably goes before surgery can make early rehab easier. I’d ask which movements are safe for your tear, and stop anything that sharply increases pain.
- Elbow, wrist and hand movement: learn the simple bending and gripping exercises you will do while the shoulder rests.
Questions to ask your surgeon
These are the questions I’d ask:
- How large is the tear, and how many tendons will be repaired?
- How long will I wear the sling, and can I take it off to shower or dress?
- What movements are allowed in the first 6 weeks, and which must I avoid?
- When does physical therapy start, and how often?
- Will I have a nerve block, and how long will the numbness last?
- Which pain medicines will I take, and when?
- When can I drive, and when can I return to my kind of work?
- Who do I call after hours if I am worried?
The first 48 hours
If you have a nerve block, the arm is usually numb and heavy for about 12 to 24 hours, sometimes longer. Keep it in the sling, as you cannot feel where it is. Your team may advise taking the first dose of pain medicine before the block wears off, often in the evening or overnight.
A block in the neck area can also cause a hoarse voice, a drooping eyelid on that side or a mild feeling of not getting a full breath. These usually pass as the block wears off.
I’d sleep propped up. Use a cold pack wrapped in a cloth over the shoulder for 15 to 20 minutes at a time if your team allows, keeping the dressing dry. Gently move the elbow, wrist and hand several times a day. Have an adult with you for at least the first night.
The weeks after surgery are mostly about logistics; set them up before you need them.
Call your surgeon or emergency number if
- Breathing gets harder: breathlessness that is severe or getting worse, or chest pain. Call your local emergency number.
- Calf swelling or pain: in one leg, or sudden breathlessness. Call your local emergency number if breathless.
- Fever: a temperature of 100.4°F (38°C) or higher, or the temperature your surgeon gives you, or shaking chills.
- Wound changes: spreading redness, increasing warmth, pus, a bad smell or a wound that opens.
- Numbness that does not wear off: well past the time your team gave you, or a hand that is cold, pale or blue.
- Uncontrolled pain or vomiting: pain the medicines are not controlling, or being unable to keep fluids down.
Related guides: Preparing for Shoulder Replacement Surgery and Preparing for Shoulder Arthroscopy.
More on this area: surgery recovery guides.
The repair heals on its own schedule; your job before surgery is to make that schedule easier to live with.
Written and reviewed by Louise Yow, Neck & Shoulder Physio. More about me. These pages explain; they don’t examine you, and your doctor’s or surgeon’s plan comes first.