“Filling” the Gap After Rotator Cuff Surgery

You may hear the term “fatty infiltration” for the first time when you see a physician about a rotator cuff injury. After you tear the tendon in your shoulder, a large gap remains between the tendon and the bones, keeping the shoulder muscle from performing its usual actions of shortening and lengthening. The body attempts to heal itself by “filling” the gap, unfortunately, with fatty tissue rather than muscle – and it remains there permanently. When muscle is replaced with fat, the result is reduced function and discomfort. Surgery cannot fix the problem, but it may prevent the infiltration from progressing further. Studies have shown that the more fatty infiltrate, the higher the risk of suboptimal healing after rotator cuff surgery.

Your surgeon may examine the amount of fatty infiltrate in your shoulder using a computed tomography scan and assess the damage by measuring the percentage of muscle the fatty tissue has invaded. Although recent research has offered some hope that certain drugs might reduce fatty infiltration after rotator cuff tears, at the moment there is not much that can be done to stop this process from happening. Postsurgery, a good physical therapy rehabilitation program can enhance the results of your procedure, regardless of the degree of fatty infiltration. An individualized program of physical therapy can help to

  • relieve pain and swelling
  • prevent pain and injury recurrence
  • develop a progressive strength-training routine
  • teach techniques you can perform at home

The sooner physical therapy is started after a cuff repair, the better. That way, we can counteract the negative impact of the fatty infiltration by strengthening surrounding muscles and helping the shoulder heal more quickly and effectively. We may not be able to get rid of the fatty infiltrate, but we can help stop further damage in its tracks with an exercise program devised especially to meet your needs.