Which factor is considered the limiting factor in rehabilitation after rotator cuff surgery?

Tendon-to-bone healing is recognized as the limiting factor in rehabilitation following rotator cuff surgery. This healing process is critically important because it directly affects the integrity and functionality of the repaired rotator cuff. The surgical procedure typically involves reattaching the tendon to the bone, and this connection must heal properly to restore strength and stability to the shoulder.

During the rehabilitation phase, early movement and strength activities must be carefully managed to avoid stressing the newly repaired tendon attachment. Premature loading or excessive movement can lead to re-tearing or incomplete healing, which can significantly impair recovery and future function. Therefore, rehabilitation protocols are developed with an understanding that sufficient time is required for the tendon to establish a secure bond with the bone, ensuring a successful long-term outcome.

Other factors, such as pain control, muscle endurance, and joint mobility, are also important in the rehabilitation process but do not inherently limit recovery in the same way tendon healing does. Pain control facilitates participation in therapeutic exercises, muscle endurance is addressed progressively once healing is underway, and joint mobility becomes a focus as the tendon heals. However, without successful tendon integration into the bone, these factors alone cannot ensure proper rehabilitation or restore full function.