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“Filling” the Gap After Rotator Cuff Surgery

Tom Willemann |

 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.
Apex Orthopedic Rehabilitation in Wyckoff, NJ provides orthopedic and sports physical therapy services for the greater Ridgewood, Wyckoff, and Bergen County region.  This blog is intended for informational purposes only and should not be used for diagnostic or prescriptive purposes. The views expressed here are the author’s views and should be taken as suggestions. Always consult your doctor or healthcare practitioner before engaging in a physical therapy or rehabilitative program.

Tom Willemann

Tom Willemann

Tom Willemann is a premier physical therapist based out of Bergen County, New Jersey. He holds an MS in physical therapy from the University of Miami, is credentialed in the world-renowned McKenzie Method of Mechanical Diagnosis and Therapy (MDT), and holds an OCS (Orthopedic Clinical Specialist) certification. As of 2018, there are approximately 14,000 ABPTS certified specialists in the nation and less than 400 of them are located in the state of New Jersey. Tom is the owner and director of Apex Orthopedic Rehabilitation in Paramus. He opened the clinic, which specializes in spine and sports injury prevention, in 2004 after many years of experience in the field. Tom’s caring interest in others and his strong belief in continuity of care, combined with his clinic’s ability to find solutions for the most difficult orthopedic problems, have earned Apex Orthopedic Rehabilitation its excellent reputation with patients and medical professionals in northeastern New Jersey and beyond. A true “family man,” Tom takes pride in his clinic’s warm and welcoming environment.
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