After shoulder surgery, physical therapy is necessary for your shoulder to become strong and flexible enough to return to competitive throwing. The therapy will vary depending on exactly what was done inside your shoulder during surgery, and not all programs are the same. Also, not all therapists are the same. There is difference in therapy for a 70 year old person’s rotator cuff repair and a cuff repair done in a twenty year old pitcher. You will be best served to have a therapist who is experienced in caring for throwers. Many of my patients come from across the state and nation, and through my baseball contacts I can help you find a good therapist in your area after your surgery.
The physical therapy will focus on regaining your range of motion (ROM) and strength without damaging the repair. This can be tricky, and is difficult to do on your own. The therapist must understand the nature of the repair and how strong it is so that the therapy can be safe and effective. Communication between the therapist and surgeon is key. Because not all therapists know the post-operative course for a thrower having a shoulder repair, I have placed my rehabilitation protocols on my webpage (www.drlintner.com). This way, my patients from other parts of Texas or the US (or any other country for that matter) and his/her therapist can look on my webpage to see the rehabilitation instructions for the type of procedure the patient had. Still, it is helpful if the therapist is familiar with throwing mechanics and has experience in caring for competitive throwers. The webpage protocols provide guidelines but there is no substitute for experienced hands for your surgery and therapy.
Once the repair has healed sufficiently, the therapy can be more aggressive to regain motion and strength. Different repairs heal at different rates. Most labral repairs can tolerate aggressive stretching after six weeks. Ligament and capsule repairs are similar. Strengthening of the rotator cuff and scapular muscles takes another six weeks or so, and the repair continues to heal during that time. Usually by three or four months the repair and rotator cuff are both strong enough to allow light throwing. Most athletes think they are ready to throw before they actually are, meaning the repair is not strong enough even though they feel good. Caution is worthwhile. If you return to throwing too soon, the repair will fail and we are back to square one.