Rotator cuff repair: considerations of surgical characteristics and evidence based interventions for improving muscle performance

Background: Rotator cuff tears may lead to significant limitations in function, pain and disability. The extent of recovery from surgical intervention and subsequent rehabilitation can vary depending on the complexities of the tear, repair procedure, and post-operative patient management. Evidence suggests that tear and surgical characteristics will influence patient presentation in terms of strength and function, and thus need to be considered when healthcare professionals design rehabilitation programs. Objectives: The objective of this manuscript is to present evidence-based rehabilitation guidelines for management of patients following repair of full-thickness rotator cuff tears, while taking into consideration the method of repair and the characteristics of the rotator cuff defect. Major findings: Many studies have examined different characteristics of rotator cuff tears, various surgical procedures to correct the deficits, and physical interventions that target the specific range of motion and strength deficits post rotator cuff repair. A significant number of investigations have reported muscle activation levels with exercises and daily activities, which may offer a prescriptive utility to the clinician providing post-operative management. However, there are insufficient evidence-based rehabilitation programs that consider the characteristics of the rotator cuff tear defect or method of repair when addressing the post-operative clinical presentation, related impairments, functional limitations and interventions. Conclusion: Rotator cuff tears and repairs have various characteristics that can impact patient recovery. Optimal recovery is dependent on appropriate communication among healthcare professionals and a rehabilitation professional’s understanding of how the tear classifications and surgical management can influence the standard treatment plan for rotator cuff repair.