Spring has finally sprung in northern Michigan and with that the fairways of local golf courses are greening up in response to the warmer weather and spring rains. While some golfers have been busy working on a new swing or trying out a new club over the winter, other golfers have spent their time diligently working on regaining their mobility, strength, and function after having a rotator cuff repair. The most common question I get from these golfers is, “When can I start playing again?”

The answer to this depends on a number of factors: the size of the rotator cuff tear, the degree of repair needed, the amount of healing that has occurred since the repair, and the extent of rehabilitation that has occurred to that point.

What is a Rotator Cuff Tear?

The rotator cuff consists of a group of 4 muscles and their tendons that work together to stabilize the shoulder joint, i.e. keep the ball seated in the socked. (In this case, it is closer to helping keep a golf ball balanced on a tee.)

A tear of one or more of these tendons, either because of wear and tear or because of a fall onto the shoulder, results in considerable pain and impairs a person’s ability to raise their arm up or reach out. As a golfer, this limits their ability to pick up and swing a golf club.

How is the Rotator Cuff Repaired?

Most repairs of a rotator cuff tear are done arthroscopically, or through small incisions in the front of the shoulder with the use of a small camera. The tear is fastened back to the bone with the use of surgical ‘tack’ or ‘pin’. The size and degree of the tear determine the number of tacks needed to securely re-attach it to the bone.

How long does a rotator cuff repair take to heal?

The bigger the tear the longer the healing process. On the average, a 4-6 week healing process is required. During this time which begins from the time of surgery, patients typically wear a shoulder sling or immobilizer which allows the tendon to heal back to the bone. The sling/immobilizer helps patients avoid stressing the repair and the healing to occur.

The orthopedic surgeon is able to tell how long of a healing process is needed based upon the size of the tear (and subsequent repair) but also based on the quality of the tissue available to repair. In addition, the health of the patient factors in: slower healing occurs with smoking and/or diabetes.

What does rehabilitation of a rotator cuff repair entail?

Physical therapy is needed after a rotator cuff repair in order to regain maximum strength and range of motion of the shoulder in order to regain maximum function, i.e. swing the golf club. Rehabilitation progresses from immobilization (4-6 weeks), ROM (6 weeks), strengthening (6 weeks), and eventually sport specific training

Return to Play Guidelines for Golfers Following Rotator Cuff Repair

1. Clearance by surgeon that enough healing time has occurred based upon their observation of the tear and subsequent repair. Typically, between 6 months and 12 months after surgery.

2. Pain free! Continued pain is your body’s way of telling you that the tissue is not ready to handle to stress of swinging a golf club. Keep working on your rehabilitation until you are pain free.

3. Full shoulder ROM. Having mobility restored keeps the repair safe and least stressed through a full swing pattern.

4. Normal shoulder strength. Having strength restored protects the repair and maximizes function in the shoulder.

5. Deviation Free Golf Swing. It’s important to be able to move the club from the backswing through the end of the follow through position without altering the mechanics of the swing. This helps to minimize stress to the repair and demonstrates that shoulder function has been restored.

Working closely with your physical therapist and orthopedic surgeon will help you maximize your recovery and get you back on the course as soon as possible!

Jeff Smith, PT, OCS, CSCS, CF-L1 is a board certified orthopedic physical therapist and certified strength and conditioning specialists at Northern Michigan Sports Medicine Center in Petoskey, MI. He is also a Level 1 CrossFit Trainer at CrossFit Petoskey. Jeff can be reached at 231-347-9300 or jsmith@nmsportsmed.com.