Healing of a rotator cuff is complicated and depends on a number of variables. Many rotator cuff surgeries will heal just fine, but others may not. The simple explanation is the shoulder is a difficult place for healing to occur, and the rotator cuff itself is a complex area.
Here are some more specific reasons why a rotator cuff didn’t heal.
Main Reasons A Rotator Cuff Doesn’t Heal After Surgery
Age is a major factor
The tendons connected to the bone begin to wear out starting at about age 30. This “wear and tear” factor varies by person, but by age 50 most everyone has some degree of degeneration which can cause a tear without any real trauma. This is sometimes called an “attritional tear.”
The size of the tear and the amount of damage affects the healing
The chance of healing is in direct relation to the depth and size of the tear. Consequently, the larger the rotator cuff tear prior to surgery, the higher the rate of failure after surgery.
Aggressive physical therapy may contribute to a rotator cuff that doesn’t heal well
If a patient returns to all their activities too quickly, this may be detrimental to healing.
If the therapy causes a lot of pain, the therapist may need to slow down the pace. Talk to one of our orthopedic specialists and physical therapist if you are experiencing pain during and after therapy sessions.
Although patients might be encouraged to return to activities before six months after surgery, most surgeons today suggest that it takes nine months to completely heal from rotator cuff injury and surgery.
Healing A Rotator Cuff With or Without Surgery
Many tears don’t require surgery. In these situations, patients may undergo injections, physical therapy, and take anti-inflammatory medications. Similar issues apply for tears without surgery.
The cause of the tear is an important factor. Was it from degeneration or an injury?
It is believed that degeneration of the tendons is the main reason a rotator cuff does not heal, and the older the patient, the more deterioration. Consider an old pair of jeans that eventually develops a hole in the knee. It is difficult to repair due to the frayed edges.
How long the tear has existed also can affect if and when it heals.