Editorial Commentary: Early Postoperative Stiffness After Rotator Cuff Repair Is Often a Good Thing

Early postoperative stiffness after rotator cuff (RC) repair is not uncommon and can be frustrating for patients and physical therapists, as well as surgeons, as it has the potential to lengthen the recovery process, and in rare instances, can lead to additional interventions such as injections or surgery. Many risk factors for early postoperative stiffness after RC repair have been identified, including duration of immobilization and timing of rehabilitation, size of tear, preoperative stiffness, and diabetes mellitus and, according to recent research, fatty infiltration of the RC muscles. Yet, there are potential benefits to early postoperative stiffness after RC repair, as research has shown that stiffness at 6 and 12 weeks postoperatively correlates with rotator cuff integrity at 6 months postoperatively, and stiffness generally resolves. At present, I do not worry about early stiffness after RC repair and do not adjust rehabilitation or intervene at an early time point except in extreme instances. I worry more about patients with extremely good motion at early time points. Future studies must focus on discerning "good" stiffness from "bad" stiffness.