Rotator Rehab

A tennis friend has had rotator cuff surgery, is struggling through rehab, and looking for some advice.  Plus, do we ever fully recover from joint surgery?

Jim Lavoie writes …

I had Rotator cuff surgery 6 weeks ago today. It has been a roller coaster ride for the first 6 weeks; two steps forward, one back.  Sometimes one step forward and two back as I do my PT every day.  The doc told me that golf was possible in three months; but tennis??

“What can the group tell me about starting to hit some ground strokes during my rehab?   Two months? Three months?   Will easy hitting affect the repair if it doesn’t hurt?   I am anxious but certainly do not want to start over.  This is not a fun rehab I must say.”

Jim, this is one that I have happily not suffered through. Any advice for him?

100% Recovered?

A tennis friend asked how my hip recovery was going and I said that I am now “at about 90% recovered.”  And he asked, “Will you ever reach 100%?”

That is a good question.  I had assumed, putting aging aside, that after surgery I will go back to being as mobile as I was before the onset of this problem.

What do you think… if you have had shoulder, knee and hip surgery, did you recover 100% of your abilities??

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18 thoughts on “Rotator Rehab

  1. To Jim Lavoie – my first hitting after rotator cuff surgery was in 7th month – 2-3 months way to risky as you will still be vulnerable to undoing the repair. My shoulder strength, flexibility got back to 100% by doing the rehab by the numbers and being patient . It was very uncomfortable experience but worth it unless you do damage by trying to do too much too soon. Find other less risky fitness, recreation activity until you are cleared to hit by your surgeon and physical therapist and your own analysis (all three, not just one ). Good luck! Winder Bill

  2. One of my hitting partners is working his way through this.

    He made the choice to follow rehab schedule….and in the meantime (after the period of keeping hitting arm immobilized) learned to hit left handed!

    he went from 2.5 strokes to solid 4.0 play in those “off court months (no serving!).

    That kept him on court and preserved his timing without prematurely injurIng his repaired shoulder.

    Does require a patient partner who understands the process and supports you for the skill progression

  3. I don’t know about rotator cuff or hip surgery but I had surgeries in the 2000’s (separately) to remove massive bone spurs over the big toe joints on both of my feet for a condition called hallux rigidus. Although I followed all of the physical therapy exercises and advice completely, I would say that I never got back full flexibility in either joint – at best maybe 90% in the left toe and 85% in the right. What’s more, there is another spur now growing bigger by the day on the right toe, but a bit off to the side from the original one. It is already affecting my movement and is re-stiffening the joint. I am not sure removal a second time is even possible. I think I may eventually have to explore an artificial toe joint or fusion, both of which have a lot of complications and downsides for tennis players. So to answer your question, I don’t think we ever recover 100% from joint surgery.

  4. Jim I know your pain. I had surgery 7 years ago on my left shoulder. I’m right handed. Rehab was slow and painful. I did the work. Doctor told me 4 months no tennis and 5 months no golf. I was scoped, not full surgery. Happy to say it is 100% and pain free. Good luck and stay positive.

  5. After my shoulder replacement I played mini tennis with my off hand just to keep eye hand coordination. It also helped my backhand when I was ready to resume .
    The biggest key to rehab is don’t do more than the Dr recommends as it is more harm than good.
    After rotator you will be stronger than ever be patient. Range of motion and scar tissue will be your biggest problem if you dont follow the proper protocol and ease back into tennis.

  6. I chose not to have the surgery after hearing so many negative reports about it. I hit two-handed forehands, backhands, volleys and serves. Looks weird but am getting more proficient. Good luck.

  7. I had open rotator cuff surgery in 2002 (tear in 3 layers / tendons and spur on acromion process which was removed ; back surgery on May 23, 2018 (decompression surgery of L3, L4, L5 and S1); and 9 surgeries on my right knee (5 replacements) and 2 surgeries on my left knee (replacement being last surgery) – college football days and meniscectomy days before scopes were used. I totally followed the PT advice on rehab with the shoulder (cannot say I did with all surgeries) and feel it is very important to strengthen (and then to maintain strength with light weights afterwards) the shoulder before hitting again. Without question you can be recovered 100% – remembering how difficult sleeping and rehab was you want to make sure that you are ready to return as repeat surgery for this is not desired. You don’t forget how to ride a bike and your strokes will still be there…….

    DBM… WOW!!!!!!!!!!!!!!!!!!!!! george

  8. Jim & George-
    I’ve had two hip replacements and one rotator cuff operation.
    By far, the rotator cuff was the worse of the two….I did not sleep lying down for three months. BUT it all works out. The key is not rushing it……I had two friends that came back too early (tennis and golf), and they blew out their shoulders for keeps……no more tennis or golf for them. You have to be patient with both operations, but you can achieve 100% speed and strength. I now move faster than I did a few years ago, and my serve is better now than it was before the surgery. Yes, I changed my service motion a little, but it worked.
    Don’t give up hope… actually works, if you’re patient and follow the therapist’s schedule.

    John, very encouraging. thanks, george

  9. Jim,

    Winder Bill is right on. I had Rotator surgery 10 years ago and it took 12 months to get back to close to 100%. I hit ground strokes at 6 months and served underhanded, no over heads nor serving for 12 months. The exercises are important and I still do to this day. Don’t push it. Stay the course!

  10. To Jim Lavoie,

    I had rotator cuff surgery 20 years ago in CT and then tore it 100% in Florida. Ten years ago I had a 3 hour surgery to repair it the second time. I will give you my experience. Don’t hit a tennis ball for 6 months with your repaired shoulder. Do a lot of walking. My wife is a PT and her education indicates if you hit with your off arm (ie left handed for me) you will heal faster and easier. People laughed at me but I kept at it and eventually played some left -handed. It will take you at least 1 year to begin to resemble your old self. But stay the course. Eventually I was about 100% healed and play tennis 7 days a week. I have no shoulder pain and take no medication. If I am not 100% I am at 95% and I love my surgeon. Also as a senior one needs to come back at a moderate pace because the inactivity during rehab causes other issues ie. Achilles, muscle tightness etc. I am available at 941-351-8098 if you would like to talk. Good luck.

  11. Thanks everyone for the good advice on the rotator cuff surgery. It helps to hear what others have experienced. Like most men I tend to be impatient but I certainly do not want to start over. George, as far as returning to 100% after a replacement that is a little tricky for us “70 something” old athletes. I had two total knee replacements at the same time in 2009. Before the replacements I was not able to play tennis for 12 years. I started playing about 6 months after but the full recovery was one full year. My knees have been pretty close to 100% since then (for my age that is). George, I think that you will move around the court as well as ever in a few months. So, I guess the consensus of the group is to do your PT religiously, listen to the Doc and your PT person, don’t give up and don’t rush back too soon. Not easy but smart.

  12. I think fully recovered can be a relative term. I have had both hips replaced since December and I am functionally 100 percent for work and daily routine–not yet for athletics but mostly because I haven’t tested the joints too much–I have been given a green light to do so but I am still not mentally ready–I don’t think we are ever “the same” but my joint deterioration was so bad that I was much more so “not the same” pre-op than I am now-it does seem that hips are the easiest joints to fully rehab post total joint replacement and I expect that you will achieve close to 100 percent recovery–you are fit, committed and analytical-an ideal patient I would think

  13. Jim, The advice above is very good with the foundation being “don’t rush it.” After 30 years in professional baseball, the throwing shoulder, which includes the rotator cuff and labrum as the big problem, was our biggest treatment/prevention. Always remember, it takes 12 months for any surgery to adequately heal. That does not mean you can’t be active before that but the program has to be progressive, gradual, and individualized. It is not a linear line to full recovery and there will be peaks and valleys. In addition, once you achieve pain-free movement and resume activities, you MUST continue a basic preventive program 2-3 times a week for the rest of your active life.
    I am sure your PT/AT is not only concerned about your rotator cuff but is also concentrating on your scapular stabilizers and core as a part of your rehabilitation. A very important phase of the rehab is/will be re-starting the skills tennis to play tennis. In baseball, we use a 28-step throwing program that gradually gets the pitcher back to throwing off a mound. Then there are phases of throwing to a batter, stimulated games, and finally live game pitching. This may take another 1-2 months. I would recommend a similar return in tennis. Phase one would be shadow swings without a racket; then progress to rackets; then ball toss racket swings; light hitting from pro-feed or ball machine; then service line to service line; then base-line to base-line; then non-competitive points play. If that all progressive well, then return to play. During this same period, do not neglect your aerobic/anaerobic fitness (bike, swim, jog, elliptical), lower extremity strength/flexibility, and core work.
    Bottom line – it is a progress. But if you have the patience and fortitude to stick with it you will fully recover. Roger Clemens had a complete tear of his rotator cuff and pitched 12 more years in the MLB after surgery!
    Good luck.

    Jim, fyi, Larry was the team trainer for the World Champion Cincinnati Reds baseball team. george

  14. Jim
    I have had both of my shoulders done. First, let me say that when it comes to surgeries I probably hold the record. Many of the gents who have already commented can attest to this fact. It is one of the most painful and longest recovery processes i have endured. In both cases, I severed 3 tendons along with the bicep tendons. I have 5 screws in each shoulder. Do your PT diligently. There will be good days and bad days. If you have a bad day look forward to the next good day. Ice, ice, ice. If you need a pain pill take it an hour before you see your PT so you get the most out of the session. DO NOT rush it! It takes time. I was hitting ground strokes(easily) in 5-6 months and serving easily in 7 months. Keep doing the PT daily to build your strength. It will take you a full year to be back 100% depending on your age and severity of your injury. Have patience. We are all anxious to get back playing, but don’t screw it up so you can never play again. Use bands, but when you do the exercise which appears above, you need to have a towel rolled up and tucked between your arm and body while doing it. Do not try to continually increase weights. A retired PT will tell you no more than 3-5 lb free weights. If your PT tells you 3 sets of 10 reps each. Do that. No more.!You don’t get extra credit for doing 4 sets of 12 each. What you get is hurt and you can cause serious damage to the shoulder.
    I am right handed. I had my right shoulder done 3 years ago and my left shoulder 2 years ago. Knock on wood, but I haven’t had one oz of pain since. I play 2-3 times per week and my range of motion and strength are even better because of all the PT. You have to suck it up and take little steps. Your shoulder didn’t tear over night. Likewise, it will take time to rehab it. You’ll thank us all for the advice Good luck!.

  15. Winder and John are right on. Having had rotator cuff surgery, patience is the key. One will experience set backs for sure, good progress and then a setback. We all heal differently. For me, it was right at a year before the serve (that motion will be the toughest to normalize) and strokes starting feeling normalized.
    And as they outline above……………….do not hasten the process…………it will only set you back. Do the due diligence as outlined and let it happen.
    Oh…………………and good luck with sleeping…………yikes………….that is the hardest…………along with the serve and overhead.

  16. Thanks Larry. Great advice. I was a baseball pitcher also for about 30 years then competitive softball for another 15 years after that so I’m sure that tennis just finished off my right shoulder. All of this advice has been reassuring that I will get better if I am patient and diligent doing my exercises. George, your site is excellent for helping us old guys out! Thanks

    Jim, glad our community was there for you. Now, you just have to be patient and follow their advice! George

  17. I had a ski racing accident in March of 2018 which resulted in a full thickness tear of my left shoulder. I didn’t immediately see a doctor since I had no range of motion and wanted to wait until I had some voluntary movement of my left arm so the doctors could give a more detailed evaluation. A few weeks later, I got in for the MRI. About 1-2 months from the time of the accident, I started physical therapy. I wanted surgery to be my last option if the physical therapy was not effective. Although the physician didn’t encourage me one way or the other, the effects of the physical therapy did work enough to get me hitting balls around 3 and half months after the accident, and playing doubles tournaments beginning in early July. I also bought an electro-stim machine that I used on my shoulder, and think it helped improve circulation in the injured areas. Although I can serve and hit overheads now, they are very weak. The rest of my game is coming along. I was told that I would have needed at least 6 months of rehab if I got the surgery, and there would be no guarantees that my shoulder would be like new afterwards. Not getting the surgery kept me inactive from playing tennis for about 3 and a 1/2 months. I think I made the right choice.

  18. Jim,
    I had rotator cuff surgery in July of 2016. Just over 2 yrs ago. I had tears in 3 of 4 muscles. One real bad, one bad and one so so. I started doing my hand crawl up the wall the first day and kept gradually doing more. I started PT at one month and went 3 times a week thru December (5 months). On other days I did 1 hour on my own. Somewhere around the end of October I started shadow tennis with a racket with no strings on forehand side. Then in Nov added shadow tennis racket with strings, 100 perfect swings a day. In Dec. I hit 25 very easy balls from ball machine with forehand every other day. Next week did 50 as easy as I could hit. Never pushed it. My backhand was about 7 weeks behind forehand on everything. I hit easy serves in March at 8 months. I was probably 90% in May at 10 months. I feel I am now 100%. 3 aces in one game in a 4.5 match today. Shows I can still hit it at 64. (Not saying this to brag just saying I can again put some muscle into it.) You can come back 100%, must take time. If you rip it again it will never be the same.
    Randy Beerman

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