Tendon Repair & PT Rehabilitation: Recovery Guide

Introduction

Tendon repair surgery is a procedure to fix torn tendons in the shoulder. It can be performed using a large open incision or a minimally invasive arthroscopic technique. The rotator cuff, a group of muscles and tendons in the shoulder, plays a crucial role in arm movement. Tears can occur due to overuse, injury, or gradual wear over time.

Common Tendon Repair Techniques

1. Open Repair: A large incision is made, and the deltoid muscle is moved to access the torn tendon. This is used for complex or large tears.
2. Arthroscopy: A small camera is inserted through a minor incision, allowing the surgeon to view and repair the damage using specialized instruments.
3. Mini-Open Repair: A combination of arthroscopy and open surgery, where damaged tissue is removed arthroscopically before a small incision is made for tendon repair.

Surgical Procedure

• Torn tendons are reattached to the bone.
• Small suture anchors, made of metal or dissolvable material, secure the tendon.
• Stitches hold the tendon in place, promoting healing.

Why Undergo Tendon Repair?

• Persistent shoulder pain that does not improve with physiotherapy.
• Loss of strength affecting daily activities.
• Requirement for full shoulder function for sports or work.

Potential Risks

• Allergic reactions to anesthesia.
• Breathing complications.
• Infection, blood clotting, or excessive bleeding.

PT Rehabilitation Phases

Phase I: Immediate Post-Surgical Phase (Week 1-6)

Goals:

• Protect the repaired tendon using a sling.
• Manage pain and swelling with ice.
• Sleep in a reclined position for comfort.

Precautions:

• No active shoulder movement.
• Maintain arm in a sling except for elbow, wrist, and finger movements.
• Avoid lifting, stretching, or supporting body weight with the arms.

Exercises:

• Shoulder shrugs and rolls.
• Pendulum exercises.

Phase II: Protection Phase (Week 7-12)

Goals:

• Gradually introduce active range of motion (AROM).
• Discontinue sling use after week 6.
• Begin assisted exercises under supervision.

Precautions:

• No lifting or jerking motions.
• Avoid supporting body weight with hands and arms.
• No excessive behind-the-back movements.

Phase III: Intermediate Phase (Week 13-16)

Goals:

• Restore full active and passive range of motion (PROM).
• Strengthen the shoulder gradually with resistance bands.
• Return to functional activities.

Precautions:

• Avoid lifting heavy objects over 5 lbs.
• Prevent sudden lifting or pushing motions.

Exercises:

• External and internal rotation with resistance bands.
• Rows with resistance bands.
• Cross-body and internal rotation stretches.
• Water therapy exercises for flexion and external rotation.

Phase IV: Advanced Strengthening Phase (Week 17-22)

Goals:

• Achieve full, pain-free motion.
• Enhance muscle strength and endurance with light weights.
• Continue range of motion exercises if needed.

Exercises:

• Side-lying external rotation.
• Forward band punches.
• Biceps curls.
• Prone scaption and dynamic hugs.

Phase V: Return to Activity (Week 23+)

Goals:

• Gradual reintroduction to work, sports, and recreational activities.
• Maintain strengthening and stretching exercises.
• Engage in an interval sports program.

Conclusion

Tendon repair surgery combined with structured PT rehabilitation ensures optimal recovery. Following a phased rehabilitation plan helps restore strength, flexibility, and function, allowing individuals to return to their daily and athletic activities successfully.