Houston Methodist. Leading Medicine

Shoulder FAQ

Question:

Two weeks ago, I had rotator cuff surgery. I'm doing the pendulum exercises the physical therapist showed me but I think these are stupid. I'm really ready to start using the arm more. Is there any reason why I can't move on now?

Answer:

Any time the rotator cuff is torn and surgery is required to repair or reconstruct the damage, patients are placed in a sling postoperatively to protect the healing tissue. Patients are then given a standard set of shoulder exercises called Codman's or pendulum exercises to keep the shoulder joint from getting stiff or freezing up. It's understandable that you want to progress your exercise program and resume more activity and motion. But we must caution you to follow your surgeon's and your physical therapist's counsel. And here's why. There's evidence to show that with large tears (complete rupture), the retear rate is as high as 75 per cent. That's three out of every four patients! Are these retears in any way linked with doing too much -- perhaps even performing the prescribed shoulder exercises incorrectly? Researchers from the Department of Orthopaedic Surgery at the University of Michigan think so. They tested a group of healthy, young adults (with no shoulder injuries) using surface electrodes (over the skin) of the muscles in question. They found that even doing the pendulum exercises can activate the shoulder muscles. For someone who had rotator cuff surgery as recently as two weeks ago, the force of that muscle contracting may be enough to disrupt the healing tissues. In this same study, they even found that lifting a simple water bottle to the lips caused the supraspinatus (most common rotator cuff tendon to be injured) to be activated. Until scientists are able to sort out how much force each activity generates, you are better off listening to the sound advice of your doctor. It makes sense to progress slowly enough to allow the tissues to heal without a retear so that you are able to get back to your daily activities without a second surgery. Joy L. Long, MD, et al. Activation of the Shoulder Musculature During Pendulum Exercises and Light Activities. In Journal of Orthopaedic & Sports Physical Therapy. April 2010. Vol. 40. No. 4. Pp. 230-237.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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