Rotator Cuff Tear Recovery Time | Timeline With And Without Surgery

The rotator cuff tear recovery time tends to be between 3 to 8 months. It’s a large gap, I know, but the truth is that tons of factors come into play while healing.

The most relevant is the treatment modality – conservative or surgical. Both work well for rotator cuff tears, but the way to recovery differs greatly between them.

Below, you’ll learn about each phase of the recovery timeline for rotator cuff tears, depending on the treatment. Here’s what we’ll cover – tap on the bullet to go to its section:

• Timeline for the surgical route
• Timeline of recovery without surgery
• Factors that can alter these timelines
• FAQs

Surgery recovery timeline for rotator cuff tears

Full recovery can take about 4 to 8 months with rotator cuff surgery. The success rate of rotator cuff repair is 81%. (1)

The goal of getting surgery is to repair your rotator cuff and prevent the tear from getting larger.

This means longer rehabilitation, which will give the repaired tendon more time to heal and prevent future re-tears. 

Here’s what an average timeline of recovery from rotator cuff surgery looks like:

Preparation for surgery – 2 to 4 weeks

This period is to prepare your shoulder for the surgery. The goal is to have your joint as strong and mobile as possible to reduce the risk of complications and have a quicker recovery. (2)

Your doctor may recommend working with a physical therapist for this. This will ensure you have an individualized treatment to increase your chances of success.

Pro tip: If possible, do your pre and post-operative rehab in the same clinic. The familiarity between you and your therapist can speed up your recovery.

Things you’ll work on:

• Rundown about what to expect after a rotator cuff surgery
• Resistance exercises to strengthen your shoulder muscles
• Stretching exercises to improve arm and shoulder blade mobility

Success criteria:

• As close to a full range of shoulder motion as possible
• No visible redness and swelling

Phase 1 – Post-surgery to week 6

Expect some shoulder pain and swelling a few weeks after rotator cuff surgery. This is part of the healing process and will subside eventually.

Ask your orthopedic surgeon about pain medication to stay ahead of your symptoms.

In this phase, the focus is to reduce shoulder pain and get your arm moving without compromising the repair. (3)

To achieve this, your orthopedic surgeon will refer you to physical therapy, so you can easily move along through your recovery.

Things you’ll work on:

• Physical therapy and medication to reduce pain and swelling
• Range of motion exercises while on a shoulder sling
• Light exercises to activate your rotator cuff muscles
• Mobilizing your shoulder blades

Success criteria:

• Minimal arm pain and swelling
• Minimal shoulder stiffness
• Pain-free assisted shoulder motions
• Ability to lift your arms above parallel with a shoulder sling

Phase 2 – Week 7 to 12

This phase is the most crucial part of your recovery.

Most people tend to stop going to rehab at this point, but it’s critical you continue – not going to therapy in this period is the main reason for surgical re-tears and failure of surgery. (4)

This is because your rotator cuff tendons are mostly healed by now, but are still weak. So, you will be focusing on strengthening your rotator cuff muscles in a safe and controlled environment.

However, refrain from lifting and/or carrying heavy objects during this time to protect your shoulder from re-tearing.

Things you’ll work on:

• Shoulder capsule stretching
• Progressive strengthening of your shoulder muscles
• Correcting the movement pattern between your arm and the shoulder blade

Success criteria:

• Full range and pain-free shoulder motions
• No visible shrugging while raising your arm
• No pain during resistance exercises

Phase 3 – Week 13 and onwards

In this last phase, the focus will be on keeping your arms stable even with large movements. So, you’ll work on posture and do stability drills to help prevent future shoulder injuries. (5)

Generally, the total length of this phase will depend on your previous activities. For example, volleyball players will need more time to get their shoulders ready as they are more prone to stress.

Things you’ll work on:

• Overhead and rotational strengthening
• Improving shoulder stability
• Proper body mechanics and posture
• Sport-specific exercises if you’re an athlete

Criteria to end rehab:

• Full range and pain-free shoulder motions, even with resistance
• No pain and stiffness after each rehab session
• Ability to carry a heavy object overhead pain-free

Recovery time for rotator cuff injuries without surgery

Full recovery through rehabilitation alone will take 3 to 6 months. Improvement tends to be quicker since you wouldn’t be compromising any graft or repair.

The goal of physical therapy is to correct modifiable impairments like weakness and tightness. Through this, you can relieve pain and dysfunction.

Fortunately, the success rate of rehabilitation as the main treatment is 80%. (2) This is what should be done to heal your rotator cuff naturally:

Phase 1 – Day 1 to week 4

The priority of this phase is to relieve your shoulder pain. Several options include pain medications, RICE therapy, heat therapy, and corticosteroid injections.

Your therapist will also work on improving the strength and mobility of your shoulder blade. This can prevent further irritation of your rotator cuff. (6)

Things you’ll work on:

• Reducing shoulder pain
• Assisted range of motion exercises
• Strengthening below shoulder level
• Shoulder blade mobility

Success criteria:

• Minimal shoulder pain and tenderness
• Ability to lift your arm above parallel, with assistance

Phase 2 – Weeks 5 to 8

This phase will focus on strengthening your shoulder joint through pain-free ranges. This will help your back and chest muscles adapt and function just like a healthy rotator cuff.

Things you’ll work on:

• Further reducing pain and swelling
• Shoulder strengthening
• Active range of motion exercises
• Stretching drills for your muscles and shoulder capsule

Success criteria:

• Full and pain-free shoulder motions
• No pain, even with resisted exercises
• No visible compensations, like shoulder shrugging

Phase 3 – Week 9 and onwards

The last phase of your recovery will focus on conditioning your muscles to the demands of your previous activities. Most exercises now are to avoid the aggravation of your rotator cuff injury.

Things you’ll work on:

• Full-range strengthening exercises for rotator cuff
• Stability drills
• Sport-specific or task-specific exercises

Criteria to end rehab:

• No reports of pain and stiffness the day after rehab
• Ability to maintain shoulder stability with daily tasks

Factors that affect rotator cuff tear recovery

The following will influence your timetable for recovery (7):

Type of injury

Fresh tears caused by traumatic events tend to heal faster than degenerative ones. This is because the tendons have not recoiled yet.

Whereas degenerative tears have plenty of microdamage, done by years of overuse. This can be very hard to heal without surgery.

Age

Younger and athletic individuals often do better after a rotator cuff injury. Their rotator cuff hasn’t had a lot of microdamage yet, and it’s easier to correct any physical deficits.

Size of the tear

Smaller tears – less than 5cm – are easier to repair and rehabilitate than larger ones. (8)

Timing of surgery

A smaller interval between the time of your injury to the day of treatment means less accumulation of fatty deposits and scar tissue. (9) These substances lead to improper healing of the rotator cuff tendons, causing pain and stiffness.

Type of surgery

Arthroscopic rotator cuff repairs have the fastest recovery timeline among the different options. (10) It only needs a small incision to repair your torn tendon. Additionally, it allows early shoulder function during the early phases of rehab.

Smoking

Nicotine decreases the delivery of oxygen and nutrients to your soft tissues. It can make it harder for your rotator cuff to heal under those circumstances. (11)

FAQS

Conclusion

We hope that this guide helps you get a good idea about the recovery timeline of torn rotator cuffs. Check with your healthcare services provider to know what is the best course of action to deal with your shoulder injury.

Resources

1. Hospital for Special Surgery. “Large study of arthroscopic rotator cuff repair reveals some surprises.” ScienceDaily. ScienceDaily, 21 February 2011. https://www.sciencedaily.com/releases/2011/02/110219165221.htm
2. Sambandam, Senthil Nathan et al. “Rotator cuff tears: An evidence based approach.” World journal of orthopedics vol. 6,11 902-18. 18 Dec. 2015, doi: 10.5312/wjo.v6.i11.902
3. Ross, David et al. “Rehabilitation following arthroscopic rotator cuff repair: a review of current literature.” The Journal of the American Academy of Orthopaedic Surgeons vol. 22,1 (2014): 1-9.  DOI: 10.5435/JAAOS-22-01-1
4. Ahmad, Shahrulazua et al. “The influence of intraoperative factors and postoperative rehabilitation compliance on the integrity of the rotator cuff after arthroscopic repair.” Journal of shoulder and elbow surgery vol. 24,2 (2015): 229-35. DOI: 10.1016/j.jse.2014.06.050
5. Lephart, S M et al. “The role of proprioception in the management and rehabilitation of athletic injuries.” The American journal of sports medicine vol. 25,1 (1997): 130-7. DOI: 10.1177/036354659702500126
6. Cools, Ann M J et al. “Rehabilitation of scapular dyskinesis: from the office worker to the elite overhead athlete.” British journal of sports medicine vol. 48,8 (2014): 692-7.  DOI: 10.1136/bjsports-2013-092148
7. Jensen, Andrew R et al. “Factors Influencing the Reparability and Healing Rates of Rotator Cuff Tears.” Current reviews in musculoskeletal medicine vol. 13,5 (2020): 572-583. doi: 10.1007/s12178-020-09660-w
8. Cho, Nam Su, and Yong Girl Rhee. “The factors affecting the clinical outcome and integrity of arthroscopically repaired rotator cuff tears of the shoulder.” Clinics in orthopedic surgery vol. 1,2 (2009): 96-104.  DOI: 10.4055/cios.2009.1.2.96
9. Raman, Jayaprakash et al. “Predictors of outcomes after rotator cuff repair-A meta-analysis.” Journal of hand therapy : official journal of the American Society of Hand Therapists vol. 30,3 (2017): 276-292. DOI: 10.1016/j.jht.2016.11.002
10. Burkhart, Stephen S, and Ian K Y Lo. “Arthroscopic rotator cuff repair.” The Journal of the American Academy of Orthopaedic Surgeons vol. 14,6 (2006): 333-46. DOI: 10.5435/00124635-200606000-00003
11. Baumgarten, Keith M et al. “Cigarette smoking increases the risk for rotator cuff tears.” Clinical orthopaedics and related research vol. 468,6 (2010): 1534-41. DOI: 10.1007/s11999-009-0781-2