About the author:

Howard J. Luks, MD

Howard J. Luks, MD

A Board Certified Orthopedic Surgeon in Hawthorne, NY. Dr. Howard Luks specializes in the treatment of the shoulder, knee, elbow, and ankle. He has a very "social" patient centric approach and believes that the more you understand about your issue, the more informed your decisions will be. Ultimately your treatments and his recommendations will be based on proper communications, proper understanding, and shared decision-making principles – all geared to improve your quality of life.

61 comments on “Rotator Cuff Healing : 4 Key Facts to Understand

  • Dear Dr Luks,

    I am 44 yrs old and I swam every day for over an hour for several months. A mild pain became more severe until I could not rotate my right arm without a lot of pain. I received a shot (cortisone?) and in a couple of weeks the pain “cleared”. However, a few months have passed, and my right arm still hurts when I rotate it. I want to get back to swimming and hope to progress competitively in Masters Swimming.

    What are my options?

    Thank you

    • Hi Andrew …
      Obviously I can not offer specific advice or diagnoses… however, given your complaints it is entirely possible that your rotator cuff is the source of your pain. Most rotator cuff related problems respond to physical therapy. I would have a shoulder doc take a look at your shoulder so you can be properly diagnosed … then he/she can recommend a treatment program catered to your needs.

      Good Luck
      Howard Luks

  • Thank you. Glad to hear that it “may” be resolved with exercise. A doctor you can recommend in the SF area? :)

    Thanks

  • I had rotator cuff repair in sept 2013 and have experienced more pain after surgery than I ever did before surgery. This was due to a work comp injury. Had two anchors placed for a partial tear. Recently, I was kicked in the same shoulder by a combative patient and have been experiencing even more pain. The surgeon ordered an MRI and the findings showed a full thickness supraspinatus tear, along with tendinitis and bursitis. The surgeon said he disagrees with the full thickness tear because of fluid build up. I would think that a radiologist would take that into consideration in his report before diagnosing a tear. I am beyond frustrated because I cannot do my job or even daily activities without severe pain. How common is it for a radiologists findings to be ignored? I feel like I am just getting put on the back burner due to it being a work comp case.
    Thank you for your time,
    Heather

    • Hi doc, I am 21 and have been through a shoulder surgery due to partial tear to my rotator and labrum and it has been about 2 years since the surgery and the first year it totally was not the same throwing a baseball and Dont know if it will ever be again but last week I threw and my arm had some suprising life to it I have been working out and eating better so could this possibly be the time my arm has been waiting for? And also chewing tobacco, will that hinder my recovery to a point that could behold me from possibly throwing 90 mph again? Any chance I come back stronger?
      Thank you, Chad..

      • It’s possible chad … throwers with partial cuff tears due to instability (loose ligaments or labral tears) can respond quite well to a full body rehab program. Don’t forget your core work, abs and gluteal muscles.Then working on pliometrics for the cuff also helps.

        Good Luck
        HJL

  • I am 59 years old and had rotator cuff surgery 4 months ago, I’m at about 25% range of motion, and still in pain when I move. Is this normal? I do not under any circumstances want to have this surgery over. This process puts a new meaning to pain. I have to return to work next week and I hope this will eventually heal. Are there any type of bandages or braces out there to help relieve some of the pain and possibly regain movement and motion?
    Thanks for any advice
    Richard

    • Hi Richard … Sorry to hear you are not doing well. Stiffness following a rotator cuff repair can hold back your recovery significantly. A number of my patients use (and like) a product called TheRotater. You can find it online. Let us know what you think. PS… I do not have a financial interest in them :-)

  • Hi Dr.Luks,

    I’m a 23 year old male and relatively new to the gym (I’ve been going for about 4 months or so). After doing some chest related dumbbell exercises I went over to a chest press machine. Before I did any lifting I pushed my shoulder back to grab the handles and heard a pop. Shortly after I had a little bit of pain and slight weakness. Five days later I still have some minor weakness and some pain. My shoulder also has been clicking occassionally. I’ve started PT on my own and that appears to help. Does a loud pop necessarily mean that the rotator cuff is torn, even if it is followed with some pain and weakness? I’m a little concerned since this has lingered for a few days. I’ve also been told that full rotator cuff tears are somewhar uncommon for people of my age.

    Thanks,
    Eric

    • You are correct… rotator cuff tears at your age are very rare. No, a pop does not imply that a tendon has torn. If the pain persists see your Orthopedist.

      Howard Luks

  • Dr. Luke,
    You state that a bone spur is not a reason to get surgery. Five years ago I had a bone spur in my left shoulder that caused pain and limited mobility. I had surgery and my shoulder still feels great today. However, I now have the same pain in my right shoulder. How do you suggest I resolve this without surgery? Will the bone spur go away by itself?

    • Hi David … For a long time this was a huge debate among shoulder surgeons. It is now very well recognized that the spur is not the likely source of pain, nor the cause of rotator cuff tears. I’m glad you did well after your surgery. When we used to go in to shoulders and take down those spurs we also had to remove the inflamed bursa to see the spur, and at the same time we cleaned up and fraying of the rotator cuff, etc. So .. in the end, you don’t actually know if it was the removal of the spur, the clearing of the bursa or cleaning up of the rotator cuff.

      Our latest series of posts is focusing on patients like you… the most common cause of shoulder pain after 30 is a process called rotator cuff tendinosis, with or without a secondary bursitis. Your doc helped you out the first time.. I hope he/she is still around to assist you now.

      Good Luck

      Howard Luks

  • Hi Dr.luks,
    Loved your article.i have a similar problem since 3 years. I am 31 female.Cannot raise my arm vertically or horizontally.Even if try hard to raise and is successful,the area below my left collarbone gets very very painful.I have had two spells of physio,one ultrasound,one MRI and two X Rays. But my problem prevails. So can you suggest which tests should I undergo to properly diagnose my problem and how long will it take to cure? Feeling desparate to get well soon :(

    • Thanks Sumana …
      Unfortunately, without examining you I can not tell you what might be bothering you.

      Good Luck !

  • Hello Dr. Luks,

    I like to refer some details of my mother’s injury for shoulder. In recent November-2014 she got injury on her right shoulder during her normal morning walk, when she suddenly fall. Immediately we had been to consult our doctor he advised that a muscle injury and told to use arm pouch for few days, but the pain was still there after few days. On advice of a family doctor of ours we had taken a psychotherapy lessons started from exercise for a month. on existing of pain on shoulder heat therapy was taken for almost 20 days. Now yesterday i had consult another doctor and undergone a MRI after which doctor advise me for shoulder rotator cuff repair through surgery. My specific question in this reference is as
    i) Does surgery is the only option, cant it can be healed with medicine or any other therapy.
    ii) The age of my mother is 68 and what are the chances for recovery in this age.
    what else option can be explore in place of surgery.

    Regards
    Gaurav

    • Surgery might be a good option … but it is impossible for me to know if it is the right answer for your mother. It depends on the size of the tear, the location of the tear, your mothers health, etc… Only a complete evaluation can enable me to give you a better answer

  • Hi, Dr. Luks,

    I am very impressed by your article, I have rotator cuff calcific tendinopathy and focal subdeitoid bursists. I had an injection a week ago by a orthopedist. Now I still feel some pain and the orthopedist ask me go back for another ject. on Monday that is tomorrow. I am very worried. Can I make a appointment to see yours soon as possible? What is your best suggestion?

    Thanks.
    Mei.

    • You can certainly make an appt to come in and see me. Feel free to call us at 914-789-2735. There is no rush… this is not an emergency situation.

      Howard Luks

  • Hello,
    Here’s my situation and quick question on your suggestions and whether I should have surgery or not. I am 25 and dislocated my shoulder snowboarding it was out of socket for about 1 hour before getting it reduced in hospital. The injury left me with a partial thickness supraspinatus tear but no other damage and my labrum was intact. I started physiotherapy immediately for the last two weeks and am in week three now. I stopped wearing the sling three days ago. My range of motion has gotten a lot better but am still missing the external rotation. I have also started seeing a chiropractor who is giving me active release technique treatments as well as acupuncture. My pain is very little but do not have all my strength yet. I work full time as a firefighter and really want to make a full recovery without surgery how long am I looking at to heal this type of injury.
    Thanks

    • It’s hard to say Jordan. Some shoulders will take longer than others to recover. As long as the nerves are functioning well and your shoulder is stable I would stick with your PT and exercises and you should see slow, gradual improvement. Recovery from shoulder injuries is always longer than we expect :-(

  • I would like to know is it possible to return to work 2 weeks after rotator cuff surgery??I am a teacher so I don’t have a physical job that would require intense range of motion on my arm…..but I can’t afford to be out of work several weeks ……

    • I personally allow you to return to work as long as you can wear your sling…
      BUT…
      Driving is an issue, and you can not be on pain medications.

      I would review this with your surgeon to get their personal thoughts.

  • Dear Dr. Lula,
    Hi I have a question. I’m a 39yr old female. About 5years ago I had an mri done which showed a rotator cuff tear. Nothing was ever done about it. Today I’m having so much pain it hurts to take a deep breath,mo e my head/neck, & or any movement of my right arm/shoulder. I’m in tearS even after taking g heavy pain meds that I take for my fused back. What needs to be done? Please help me this is such a horrible pain.
    Thanks so much Dr. Lula

  • I have been diagnosed with partial tear rotary cuff…pain not bad and doing strength exercises as prescribed by dr. I am a swimmer… Could this have caused it…I haven’t swam since and am afraid to… Will it cause further damage or improvement…will the tear become bigger..,I am confused please advise

  • Dr.H Lucas, Four weeks ago while sparring, I threw a wide/high left hook and missed. Felt something in my shoulder toward the back, can’t explain it because adrenaline. I have been taking it extremely easy since then; no lifting or training. It only hurts if I lay in bed at night with a baseball pitchers arm motion(Owens test) and it is a dull pain or hanging my arm out of the window of my car and still dull pain. I tried the labrum/rotator cuff tests which are shown by Dr’s on youtube but obviously unsuccessful. Wanting to get back should I wait another week or make an appointment? Have weak insurance where I live so any information given is extremely appreciated. Thank you very much for your time, Jw

    • JW .. There’s little harm in waiting another week or two and trying to stretch it out and do some light resistive work. No sparring, etc. If you do not notice improvement then I would see an sports doc

  • Hi Dr. Luks,

    On 2/17/15, my surgeon performed arthroscopic surgery of the right shoulder for a full thickness supraspinatus tear. I was in a sling for 6 weeks and attended PT 3x/week for 17 weeks. The last followup with the surgeon was very encouraging. I have almost complete ROM with some good strength building up. Yesterday, 6/26/15, I took a small, patio level dive in the pool and in the middle of completing my initial underwater stroke, I felt a sudden stretching pain in the repair area that frightened me. I woke up this morning with some stiffness and feel some light to moderate pain in certain arm positions (sometimes even just leaning over). It’s difficult to describe the sensation, but I would say it’s sort of like a tangle of tendons/muscles that dissipates as I engage the area. I’ve been extremely paranoid about re-injuring the tendon and as such I’ve been very cautious with it. The dive was calculated and controlled (which I’ve done several times in the past 2 weeks with no issues). I’m so fearful that I may have torn it again. I realize you can’t provide a diagnosis. But I’d love to know what “normal sensations” at this stage of my recovery I should expect? Before the incident, I felt practically no pain/discomfort. Since the incident, it’s sort of sore and stiff.

    Thanks for your time!

    • There are many “normal” sensations after a rotator cuff repair. But keep in mind that up to 40-50% of rotator cuff repairs actually fail — which means the tendon doesn’t heal — BUT BUT BUT, the patient still feels fine. It sounds unusual but it is true. You do not need a fully repaired cuff to be comfortable. Anyway… continue with your activities… stretch, warm up and nothing quick or abrupt. The risk of re-injury is highest 20-24 weeks after surgery. Read Ianotti’s paper out of the Cleveland Clinic. If your pain and discomort persist after another few weeks then check in with your doctor. http://jbjs.org/content/95/11/965

  • Thank you Dr. Luks. That was interesting considering the time span between 20-24 weeks for re-injury to occur happens to coincide with my shoulder feeling relatively good and strong. I could see how feeling much better at this point one may take certain things for granted and start doing things that would otherwise be inadvisable. My shoulder experience in the pool makes me feel like I regressed to the point in PT where I went from passive ROM to active. Before this incident, I also stopped going to PT for about 2 weeks precisely because I was feeling so much better. I can’t help but wonder if that 2 week period actually weakened my gains.

  • I presented to the doctor that my left arm could not be raised sideways above the horizontal and if stretched out in front was about 25/35cm shorter than the right, if I raised my arms up the left curved out and the right was straight. It has only become evident in the last 6 months of general gym work that I noticed these disparities.
    X-Ray showed a few ossicles lateral to the acrimonium (possibly from an old fracture) and narrowing of the subacromial space indicative of tear of rotator cuff tendons
    Ultarsound showed that the supraspinatus tendon has a full thickness tear with a retraction of around 13mm and a tear of the infraspinatus resulting in a retraction of the muscle of 14mm
    I am not sure at my age 62 that surgery to reconnect the tendon is an option. I have had Frozen Shoulder in this arm (took 3 years to get over) before but apart from some weakness in certain resistance exercises no other issues.
    The interesting thing is that I have no knowledge of a fall or such that would explain this injury – I ma right right handed and non-diabetic and I have experienced 90% tear in right shoulder with rotator cuff tear of infraspinatus. So i know the sort of pain. Could I have been carrying this injury since/after birth – my earliest childhood recollections go back to age 3.
    Of interest thx.

  • Hello Doctor,
    I’m a 57 year old female. I developed joint problems after chemo for non-hodgkins lymphoma, Leviquin, and a radiated drug called Bexxar. I have been in remission for five years. I exercise a lot, am very active and play the violin. My right shoulder is limited in movement and causes me a lot of pain, even at night. I’ve tried resting it, have had two steroid shots and an MRI. My doctor says I have bursitis, a minor tear and a bone spur. He is not pushing surgery but I have tried the other treatment options, only to have it worsen. Is this a fix it or live with it situation? I would appreciate any advise. Thank you.

    • Sounds like a frozen shoulder ??? Which is simply a shoulder that has less movement than normal. If PT is not effective, there are surgical alternatives — that do not include bone spur removal. I would consider another opinion.

  • Hi Dr. Luis,

    I met with my orthopedist today for a rotator cuff partial thickness tear and degenerative changes. I am a wheelchair user since 2013 and play competitive wheelchair tennis, so he decided it would be in my best interest to do an arthroscopy to access/fix the tear, remove the spur and access the level of arthritis. I cannot find anything online regarding recovery of rotator cuff tears and are a complete wheelchair user. I would like to know the level of care would be required. Are there supports/equipment available to provide some level of continued independence? I realize increased care would be required, but how much. Also, do you know where I may be able to locate information on shoulder surgery as a Parapeligic ? Any information would be helpful.

    Thank-you,
    Denise

    • Tread very lightly when it comes to shoulder surgery when you are confined to a wheelchair. Surgery is the last option we consider for degenerative rotator cuff disease and partial tears.

  • I’m having surgery for the following:
    Rotator cuff
    3 bone spurs
    Severe arthuritus
    Shoulder impingement
    Shoulder is partially out of socket also
    How long will I be off work. I have an office job.

  • Thank you. My surgeon first said at least 6 weeks, so I put the surgery off. I saw him this week to schedule surgery and he said 2-3 weeks.

    I also have several cysts from chronic inflammation. I injured my arm about 15 years ago and have dealt with the pain long enough.

    It just seems like I have a lot of issues with my shoulder, so recovery may take longer.

  • I am a 54 year old very active female (yoga/mountain biker) I have a 60% tear of the supraspinatus muscle. My doc is recommending 6 weeks of PT….my question is….what is the likelihood of this healing WITHOUT surgery? I have been using a tens unit and anti-inflamatories on my own for the past month.

    • The pain has a good chance of subsiding… the tear has little chance of healing. If PT doesn’t help then you may want to explore other options.

  • H dr.luks
    I am 80 years old I went to see an orthopedic dr. For my shoulder stiffness he check my shoulder and he suspect a tears in the rotator cuff and ask me if I have a continuos pain. I don’t have a continuous pain
    I have pain only if I left my arm over my had and some other movement. He did not recommend surgery
    He said he I’ll consider surgery If I have continuous pain. And he recommend therapy consider my age
    He did not consider MRI at ths moment. Is he correct

  • I am 59 years old I tore my rotator cuff last May 11,2015 at firs the pain was extremely bad but starting this month I feel better but still it still hurt if I reach my back, when I’m lying down and push myself to position.impression after MRI.
    1.AC joint degenerative and type 3 carom ion resulting in impingement. 2.Distal rotator cuff tendinoses with small intrasubtance tear of supraspinatus tendon and questionable insertion tear. 3.interval edema suggestive of tear. 4.Abnormal superior labrum signal suspicious of tear. 5 .subacromial and subdetoid bursitis. I am still active and work fulltime,constantly pick up 6lbs that will total to 800lbs during my work. will really appreciate for the best option of treatment that you will advice.Thank you so much.

    • You have non-surgical options too with a reading like that… consider a second opinion and understand that degenerative tendinosis will worsen over time — no matter what you do.

  • Hi Mr Luks, I had rotator cuff surgery a little of 8 months ago, I went back to work at the 6 month mark and I am a Ups Driver, I was still pretty sore when I went back to work and figured the job I do will strengthen the shoulder instead of continuing pt which I also stopped at 6 months.i definitely have improved but I am still sore pretty much everyday , my doctor said it could actually take up to a year to be pain free. Does that sound normal to you, the length of my recovery and should I be doing strengthening on the side like I did at pt? Thank you

    • Hi billy ..
      It is not uncommon for it to take a long time to feel better. But keep in mind that re-tears can occur up to 6-7 months after surgery. It takes a lot longer for tears to heal than most people think. So don’t push it too hard.

  • I have after a year of painful suffering been told I have a rotator cuff injury and finally my doctors have referred me to an ortho specialist – my concern is I also have a large lump on my neck which my GP thinks is part of the rotator cuff injury. Can you tell me if this is something you have ever come across before or should I be looking for a second opinion. Thanks in advance.

  • After 4 months of shoulder pain I got an MRI done that shows a full thickness tear of the rotator cuff. I’m 62 and don’t remember any injury. The one exercise I like , tennis, seems to aggravate the shoulder even though I don’t use my left arm much. I’ve developed one arm shots to replace my former 2 arm shots.

    I’d rather not do surgery so I’m wondering if you have an opinion on the use of stem cells. Supposedly this therapy works pretty well with partial tears, but I don’t know about full tears.

  • Hello Dr. Luks, generally, after a full thickness tear repair, do you let the patient stop using the arm sling? Is there a procedure you use? IE can be off at home and during the first phase of PT, totally done with it by?
    thanks

    • Th time in a sling can vary… but it is usually 4-6 weeks — and I do not allow people to remove it often. the risk of failure is too high if you move too much.

    • I have many patients fly in and out within a week to 10 days after surgery. They return 5-6 weeks after surgery for another evaluation.

  • I am a young archer, at the beginning of the season. In the next few months i have nationals in a few several large cometitions at national and international level. I just injured my rotator cuff, however. I obviously am not able to take a month or two off training to recover. Is there any quick fix or at least something to keep most of the pain at bay until the end of the season? I have tried stretches and exercises but they dont make much difference.
    Some details: while shooting, i have to rotate my shoulder under 46 pounds of pressure, then hold it up for about 7 seconds, very still.
    Thanks

    • No easy answer here Matt… like marathoners who want to compete in a month who have a severe injury. Hopefully your stretches and rotator cuff exercises help over the next month — they are generally not a quick fix.

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