rotator cuff repair recovery

Day Case Rotator Cuff Repair Less Risky Than Hospital Stay After Surgery 

A new study has revealed that day case rotator cuff repairs could be less risky than hospital stays after surgery. The results, published within the Arthroscopy journal, could prove useful to patients and surgeons in terms of recovery. 

Here, we’ll look at the new study and its findings, alongside the common risks and complications associated with rotator cuff repair. 

Understanding the study into rotator cuff repair recovery

The new study compared the rate of 90-day post-surgery complications between inpatients and outpatients who had undergone rotator cuff repair. It included 2,812 patients who underwent surgery between 2007 to 2015. Inpatients were considered those who stayed for one or more day in hospital. Outpatients on the other hand, were released the same day.

It discovered that within 90 days, inpatients had a greater incidence of complications than outpatients. In particular, inpatients had greater medical adverse effects, as well as surgical adverse effects. Other risk factors identified included anxiety and depression, alongside a greater Charlson comorbidity index score. 

This isn’t the first study to reveal the potential complications from inpatient care. Hospital stays are considered to be riskier for a variety of reasons, including the increased risk of infection. So, evidence suggests the best course of treatment for rotator cuff repair patients is to undergo the procedure as a day case.

What are the risks and complications of rotator cuff repair?

Whether you undergo rotator cuff repair as an inpatient or outpatient case, there are risks and complications to be aware of. While most repairs see patients experience an increase in shoulder strength, as well as a reduction in pain, the following complications and risks can occur:

  • Anaesthesia complications
  • Damage to blood vessels and nerves
  • Stiffness
  • Infections

As with any type of surgery, there are risks associated with anaesthesia to consider. These include the risk of a blood clot, heart attack or stroke. However, these types of complications are rare. 

Another rare complication is potential damage to the blood vessels and nerves. It is estimated around 1% to 2% of patients experience this complication. Even fewer patients experience an infection, with rates estimated to be 0.16 to 1.9%. 

The most common complication is stiffness, with around 20% of patients experiencing the issue. However, if you do experience stiffness, generally it will go away by itself within six months. 

What factors can impact rotator cuff repair recovery?

There are a number of things that can impact how well patients recover from rotator cuff surgery. The surgical approach used, the quality of tissue, the size of the tear and the rehabilitation method all make a difference to potential complication rates. During your consultation, your London Shoulder Specialist will discuss in full any potential complications.

Overall, the new research suggests patients recover much better and safer when they are treated as a day case. This, alongside a good understanding of the risks and complications, can help patients and surgeons determine the best course of treatment.

shoulder surgery recovery

What to Expect from Your Shoulder Surgery Recovery?

Undergoing shoulder surgery is an effective way to treat numerous shoulder issues. However, it’s important to understand what to expect in terms of recovery.

If you want to experience the best results, it’s crucial to follow the surgeon’s aftercare advice. If you’re not sure what to expect from shoulder surgery recovery, below you’ll discover everything you need to know.

Shoulder surgery recovery: immediately after

After undergoing shoulder surgery, you will typically stay in hospital for 3 hours or so. This is for monitoring purposes, ensuring you are OK to go home. Once you have fully regained consciousness, your surgeon will provide you with aftercare advice.

This will usually include advice on how to manage pain, take care of your wound and control any inflammation which may present. It’s really important that you follow this aftercare advice if you want to experience the best results and limit complications.

Shoulder surgery recovery: keeping the shoulder supported

Many patients may need to keep their shoulder immobilised for a set period of time. This means you will be given a sling to wear. You may be advised to wear it for 1 –2 days or up to 6 weeks depending upon the extent of the surgery carried out.

During this time, you’ll want to wear comfortable clothing and don’t be afraid to ask friends and family for help with daily tasks.

Shoulder surgery recovery: managing pain and discomfort

One of the main side effects of shoulder surgery is pain and discomfort. It’s common to feel some level of pain after surgery, but this can usually be managed with pain relief medication. Your surgeon may prescribe medication for you to keep the pain at bay. They will also advise you on the different pain-relieving methods you can use, such as an ice pack.

Shoulder surgery recovery: issues with sleep

You may experience some issues with sleep for a few weeks after the surgery. You won’t be able to sleep on the shoulder that was operated on. This may mean that you need to sleep differently to usual. The pain can also make it harder to sleep, though pain medication will help.

Shoulder surgery recovery: rehabilitation

Your rehabilitation period will differ depending upon the type of surgery you had. However, it will include some level of physiotherapy. You will also start to introduce daily tasks back into your life, gradually building up the strength in the shoulder.

You may need to have time off work, depending upon the type of job you carry out and the nature of the surgery. If you work in a more physically demanding job role, you may need to take a little longer to recover before going back.

If you participate in contact sports, you unfortunately may be advised to delay your return to play for four to six months, depending on your individual circumstances. This can be difficult for athletes, but it is crucial for the healing process.

The above is a brief guideline on what to expect from shoulder surgery. Your London Shoulder Specialist consultant will be able to give you the best idea of what to expect based upon the actual surgery you have having. Call 0203 195 2442 to arrange your consultation.

frozen shoulder and diabetes

Frozen Shoulder and Diabetes

A new study, published within the Journal of Shoulder and Elbow Surgery, has discovered a link between frozen shoulder and fasting glucose levels. The association between frozen shoulder and diabetes is nothing new, but very little is currently known about the link regarding fasting glucose levels.

Interestingly, a link was discovered in fasting glucose levels of 90-99 mg/dL which are considered to be normoglycemic. Levels below this range haven’t shown any corresponding connection. In fact, fasting glucose levels under 85 mg/dL showed a negative association.

So, there is certainly a link between the shoulder and blood sugar levels. The question is, what is the relationship between frozen shoulder and diabetes?

Frozen shoulder and diabetes

The American Diabetes Association states that around 10% to 20% of those with diabetes, go on to suffer from frozen shoulder at some point in their lives. When you consider the rate is just 2% to 5% in the general population, you can see the increased risk diabetes poses.

Frozen shoulder is otherwise known as adhesive capsulitis and it progresses slowly over time. It occurs as the ball and socket joint of the shoulder starts to lose its mobility.

Eventually, it becomes frozen or immobilised. This means the arm cannot be moved over the head and daily tasks become extremely difficult.

It is thought that the condition can be triggered by high blood sugar levels. These attach to the ligaments and tendons, causing them to become weaker and stiffer. In turn, this causes inflammation. When you combine this with the circulation issues caused by high blood sugar levels, it can worsen the stiffness in the socket.

Generally speaking, the longer a patient lives with diabetes, the bigger the risk there is it will lead to frozen shoulder.

The importance of early treatment

Although it can be challenging to identify the symptoms of frozen shoulder early on, the sooner you can seek treatment, the better. Patients who do have diabetes should take care to control their blood sugar levels. This is the only way to reduce the risk of developing diabetes-related frozen shoulder.

For patients who are experiencing frozen shoulder, treatment includes physiotherapy and anti-inflammatory medications. Steroid injections can also prove useful. However, for those with diabetes these aren’t always suitable as they can lead to high blood sugar levels. In severe cases, surgery may be required to correct the issue.

If you are worried you might be experiencing frozen shoulder, book a consultation with a specialist today. They will be able to diagnose the cause of the condition and recommend the best course of treatment moving forward.

golfers and shoulder surgery

Most Golfers Return to Sport Six Months Post-Shoulder Surgery

Due to the repetitive movements in golf, it isn’t uncommon for golfers to develop shoulder issues. In severe cases, surgery may be required, and this can be a worry for golfers in terms of recovery and time out from the sport. However, a new data review has revealed that most golfers return to sport within six months after shoulder surgery.

Here, we’ll look at what this new golfers and shoulder surgery study revealed and what you can expect if you are due to undergo surgery for the shoulder.

Golfers and shoulder surgery study

The review, entitled ‘Return to Golf After Shoulder Arthroplasty: A Systematic Review”, assessed the return rates of golfers who undergo shoulder surgery. Published in The American Journal of Sports Medicine, there were ten studies included in the review.

A couple of the studies looked at golf performance after the surgery. Three of the studies also addressed return to golf rates for patients who had undergone total shoulder arthroplasty and shoulder hemiarthroplasty. These studies revealed a return to golf rate of 89% to 100% within 5-8 months. An additional two studies also showed 77% and 100% return to golf rates within 5.8 months.

After assessing all of the studies, it was determined that total shoulder arthroplasty resulted in a good return to sport outcomes.  Just one study focused solely on patients who had shoulder hemiarthroplasty and their return rate to golf was 54% within 6.5 months.

Reverse shoulder arthroscopy sees drop in results

Although a total shoulder arthroplasty did show high return to sport rates, a reverse shoulder arthroscopy produces slightly less favourable results. After 5.3 and 6 months, return rates were 50% and 79%. So, this type of surgery does appear to lengthen recovery time for patients.

A reverse shoulder arthroscopy is carried out where a total arthroscopy isn’t ideal. This includes patients who have suffered large rotator cuff tears with the development of complex arthritis. The reason it can take longer for patients to recover from this type of procedure is that it reverses the metal ball and socket. This causes different muscles to be used.

Helping patients understand their options

Recommendations for treatments weren’t able to be provided in the study due to varying patient baseline characteristics and surgical procedures carried out. However, it does allow patients to understand how surgery could impact their chances of returning to the sport.

Generally speaking, a total shoulder arthroscopy does produce high return to golf rates. However, like any surgery, there are risks involved that patients need to be aware of. Golfers need to understand the risks before making a decision, particularly if there is a chance they may not be able to return to the sport. The earlier treatment is provided, the more chance there is the patient will be able to return to golf.

This new golfers and shoulder surgery research does provide hope to patients that they do stand a good chance of returning to sport after their operation. With the right aftercare, golfers could be back to the sport within six months.

To book an appointment with the London Shoulder Specialists, call +44 (0) 203 195 2442.

rotator cuff disease risk factors

UK Study Identifies Risk Factors That Increase Need for Shoulder Surgery

Rotator cuff disease, or trauma to the rotator cuff, is a common complaint and can be caused by an injury, overuse whether due to sporting endeavour or employment, or can occur without any obvious cause.

A new study has helped to identify risk factors that increase the need for shoulder surgery as a result of rotator cuff disease. The population-based cohort study is one of the largest of its kind. Here, we’ll look at what it revealed, and you’ll discover more about rotator cuff injuries.

Understanding the new study

The recent large-scale study included data from 421,894 patients, with 47% being male. Participants were aged between 40-69 and the UK’s Biobank was used for the research. NHS inpatient records were used to identify patients who had undergone surgery for rotator cuff disease.

Hazard ratios were calculated using Multivariate Cox proportional hazards regression. The main risk factors discovered were sex, age, race, BMI, smoking, occupational demands and the Townsend deprivation index.

Interestingly, the study found that every additional 10 years of age contributed to a 55% increase in surgery rates for rotator cuff disease. A high BMI, non-white races and a lower deprivation score also contributed to an increased risk of surgery.

The majority of the risks identified are known to be modifiable. This means the risks can be reduced through healthier lifestyle choices.

The link between depression and rotator cuff tears

Although this new study is one of the largest of its kind, there have been previous smaller studies carried out that are worth referencing. In 2019, a study looked into the link between depression and rotator cuff tears and it produced some surprising results.

Depressive disorders are known to be associated with chronic systemic inflammation. Depression, for example, is associated with chronic diseases such as coronary artery disease and chronic obstructive pulmonary disease. So, how does this link to rotator cuff tears?

Although the underlying mechanism of how depression is associated with rotator cuff tears remains uncertain, it’s thought that inflammation not only plays a role in the onset of tendon injury but also then negatively impacts repair of injured tendons. Furthermore, depression could heighten the sensation of pain associated with rotator cuff disease in those patients suffering from depression.

Further research is needed to determine exactly how the two conditions are associated. However, the evidence so far does support they are connected. Patients with depression are more likely to require surgery for a rotator cuff tear than those without the mental health condition.

What is a rotator cuff tear?

The rotator cuff of the shoulder consists of numerous muscles and tendons which cushion the shoulder joint. It is responsible for keeping the upper arm bone within the shoulder socket. A tear can occur in any of the muscles or tendons surrounding the joint.

Usually, rotator cuff tears are caused by overuse or repetitive motions. However, they can occur as a single injury. They vary in severity and in some cases, surgery may be the only way to repair the injury.

While surgery can be an effective solution to the pain and lack of mobility associated with a rotator cuff tear, there are always risks associated with surgery that need to be considered. The new study suggests that healthier lifestyle choices may reduce the need for surgery. If you suspect you have rotator cuff disease, call 0203 195 2442 to arrange a consultation with the London Shoulder Specialists.

rehab after shoulder replacement

NICE Recommend Rehab Same Day as Shoulder Replacement Surgery

The National Institute for Health and Care Excellence (NICE) that provides guidance, advice and information services for health professionals, has issued new advice for patients undergoing a hip, knee or shoulder replacement. After undergoing surgery, patients should now attend rehab on the same day. This should be provided by an occupational therapist or physiotherapist.

Here, we’ll look at why the new guidance has been supplied and what shoulder replacement surgery involves.

Why is same day rehab recommended?

The new guidelines have been introduced after NICE consulted with the Association of Trauma and Orthopaedic Chartered Physiotherapists (ATOCP). It is known that early rehab can lead to much better outcomes for patients who have undergone joint replacement surgery.

Shoulder replacement surgery can result in a long and painful recovery. So, if patients can minimise the pain and discomfort through same day rehab, it’s a welcome change to the guidelines.

The only potential issue that could cause debate amongst the sector, is that in the small print, initial intervention could be carried out by any member of a therapy team provided they are qualified. Many experts claim the initial rehab should only be carried out by a physiotherapist or occupational therapist.

What does it involve?

The new guidelines mean that patients who undergo shoulder replacement surgery should receive the following rehabilitation therapy:

  • Advice on how to manage daily activities
  • Home exercise programme
  • Ambulation

The guidelines have been designed to be vague enough for clinicians to use their own expertise to decide upon appropriate care for each patient.

Understanding shoulder replacement surgery

Shoulder replacement surgery is carried out to treat a damaged or worn away shoulder joint. This typically occurs due to injury or shoulder arthritis. Either part, or all of the joint will be replaced using artificial parts.

There are different types of shoulder replacement surgery you can undergo. These include reverse, total and partial shoulder replacement. The reverse shoulder replacement tends to be the most common technique used. The standard total shoulder replacement remains the most common. This includes a metal ball being attached to the shoulder blade where the socket was. Then, a new socket is attached to the top of the arm, where the ball was. It basically switches the ball and socket around.

A total shoulder replacement surgery is also common. This technique replaces the ball and socket, but it keeps them in the same position. A partial replacement focuses on just replacing the ball of the shoulder.

Each surgery is designed to help patients improve shoulder motion and eliminate pain. The primary aim is to alleviate pain and hopefully also gain more function and movement The artificial parts used are typically made from metal, plastic, or a mixture of both materials.

Most patients who undergo shoulder replacement surgery are aged 70 or over. Most replacement joints will last at least 10 years before another procedure is required. There is a 10% failure rate at 7 years

The new guidelines issued by NICE ensure patients have the best chance of recovery. Being able to improve results by offering early rehab is going to prove welcome news to both patients and shoulder specialists.

If you think you might need a shoulder replacement, book a consultation with the London Shoulder Specialists today. The earlier treatment is sought, the better the outcome will be.

rotator cuff repair review

Rotator Cuff Repair Reviewed

Published last year in the Annals of the Royal College of Surgeons and now available to the public, is an in-depth analysis of research conducted in the field of rotator cuff repair titled. ‘Degenerative rotator cuff tear, repair or not repair? A review of current evidence’. The goal was to address whether a surgical or non-surgical approach would be better for patients. Among the study’s authors were three members of the London Shoulder Specialists; Mr Ali Narvani, Mr Steven Corbett and Mr Andrew Wallace.

Here, we’ll review the evidence that was revealed and what it means for those suffering from a rotator cuff tear.

Clinical outcomes for non-surgical repairs

In our analysis of research relating to clinical outcomes for non-surgical repairs, we found results were dependent upon the severity of the tear. The review focused on a multicentre study which included 452 patients who had atraumatic rotator cuff tears. They were treated with physiotherapy and reviewed at 6 and 12 weeks. Significant improvements were identified at both the 6- and 12-week review, although after two years, 26% of patients chose to undergo surgery.

It appears non-surgical treatment provides great early results, but patients still often go on to need surgery. Those with large and severe rotator cuff tears experienced the fewest benefits of non-operative treatment. In fact, for older patients with massive tears, the problem simply became worse over time. This is particularly true for patients with tears that affected three or more tendons.

Clinical outcomes for surgical repairs

A lot of studies have been carried out to determine the effectiveness of surgical rotator cuff repair. In one study which involved data from 1600 patients, it showed after six months there was a significant improvement in most patients in overhead motion and pain.

Another looked at surgical repair of full thickness tears. A total of 263 shoulders were included in the study. After five years, 94% of patients didn’t require any further surgery. Most impressively, after 10 years 83% of patients still didn’t require additional surgery.

So, surgical repair does appear to be more effective in the long term. However, it did take six months for patients to experience full improvements. This is slightly longer than the initial outcome for non-surgical treatment.

The role of age in rotator cuff repair results

There were conflicting results in the studies regarding whether age played a role in results. It is widely believed that age does impact the outcome of rotator cuff repair. However, some studies showed that there were no differences between the results experienced in younger age groups and those in older groups.

The only exception here is tendon healing. Evidence suggests that older patients do appear to take longer to heal when tendons are damaged. However, for most rotator cuff repairs, surgery had the same success rate in older patients as it did in younger ones.

The findings of the review confirm that rotator cuff repair surgery does tend to be the best option for patients. However, it does depend upon the size and severity of the tear. For patients experiencing a mild tear, physiotherapy and a non-surgical approach can be effective. However, for more severe and larger tears, surgery is the most effective option.

During the current COVID-19 crisis, all non-urgent / elective surgery bookings and appointments are postponed. These are now restarting though there are some restrictions in a quickly-changing landscape, but the London Shoulder Specialists are still available for consultation if you require more advice on rotator cuff repair. Consultations can be carried out either by telephone or video link and can be arranged by emailing or by calling 020 3195 2442.

Calcific Tendonitis Treatment

New Study Finds Calcific Tendonitis in the Shoulder Can Predict Rotator Cuff Tears

A new study published within the Arthroscopy journal, has revealed calcific tendonitis in the shoulder could predict a rotator cuff tear. Researchers were trying to determine whether calcific tendonitis could protect the shoulder from a rotator cuff tear, or whether it was an indicator of the condition.

Here, we’ll look at what the latest study revealed and the link between calcific tendonitis rotator cuff tears.

The results of the study

The new study analysed 318 shoulders which had calcific tendonitis. Researchers looked at the charts of the patients from a single clinic dating from January 2010 to April 2017.

MRI and anteroposterior radiographic studies were reviewed by a radiologist. They looked for the size, morphology and the distance calcific tendonitis was away from the rotator cuff insertion. They also looked for any signs of a rotator cuff tear. A second radiologist then confirmed the results.

It was discovered that 56% of calcific tendonitis cases in the shoulder also had a rotator cuff tear. Out of the 177 rotator cuff tears, 164 of them were partial thickness tears, while 13 were total thickness tears. It was determined that rotator cuff tears associated with calcific tendonitis had an odds ratio of 1.8.

What is calcific tendonitis?

Calcific tendonitis is the build-up of hydroxyapatite on the tendons surrounding the rotator cuff. It tends to be much more common in women than it does men and tends to affect those aged between 30 and 60 years of age.

The condition can cause intense pain around the shoulder which can either be long-lasting or intermittent. This is caused by the body’s inflammatory response to the reabsorption of calcification. The cause of the condition isn’t known, though there is an increased risk for those who have Diabetes and thyroid gland dysfunction.

Sometimes, the condition can cause it to feel like the shoulder is catching. This is a very similar sign of shoulder impingement, making it sometimes difficult to diagnose first time around.

Understanding rotator cuff tears

Out of all shoulder injuries, rotator cuff tears are the most common. It can have a significant impact on your daily life and prove to be extremely painful. They are largely caused by degeneration of the tendon and muscles associated with age. However, they can also occur due to injury caused by an accident or trauma.

Signs of a rotator cuff tear include a stabbing or dragging pain within the shoulder. The pain tends to worsen at night, making it difficult for the patient to sleep. Moving the arm to the side or forwards will be extremely difficult and it will have a significant impact on the quality of life.

If you are experiencing shoulder pain, it is important to get the problem looked at as soon as possible. The longer a shoulder injury is left untreated, the worse it becomes. If you suspect you may have calcific tendonitis or a rotator cuff tear, book a consultation with a shoulder specialist to receive an accurate diagnosis.

During the current COVID-19 crisis, all non-urgent / elective surgery bookings and appointments are postponed, but the London Shoulder Specialists are still available for consultation.

Consultations can be carried out either by telephone or video link.

Appointments can be arranged by emailing or by calling 020 3195 2442.

shoulder surgery consultation

What to expect at your shoulder surgery consultation

The unique and complex anatomy of the shoulder joint means it has the greatest range of motion, but also makes it most susceptible to repetitive injuries, ageing and stress. Most problems in the shoulder involve the muscles, ligaments and tendons rather than the bone.

Shoulder pain can be the result of a number of conditions, including trauma to the shoulder, rotator cuff damage, tears to the glenoid labrum, acromioclavicular (AC) joint injury, frozen shoulder or instability and dislocation.

Many shoulder injuries can be addressed at home through RICE method – Rest, Ice, Compression and Elevation – but you should arrange a consultation with a shoulder specialist if you’re experiencing the following symptoms:

  • Your shoulder joint looks swollen and deformed
  • Intense pain around the shoulder
  • Inability to move the shoulder or perform normal activities
  • Audible popping or cracking sound
  • Shooting pain down the arm
  • Numbness or weakness in the arm or hand

During your shoulder surgery consultation, your London Shoulder Specialist will take a full medical history. In particular, assessing the degree of pain, loss of function and sleep disturbance you’re experiencing. Details of your symptoms and your lifestyle – sporting activities you enjoy regularly or type of employment – will guide the diagnosis.

They will also discuss any other treatments you’ve undergone and perform a physical examination to assess the range of motion and strength in the shoulder.

If required, your London Shoulder Specialist will order imaging tests. X-rays do not show the soft tissues but can be used to identify changes in the shoulder blade shape, bone spurs or fractures. An X-ray can assess wear or tear of the ball and socket or collar bone which would indicate osteoarthritis. An ultrasound can reveal tears in the tendons or impingement. At that point, you may require an MRI which will deliver a much clearer image of the soft tissues.

Questions to ask your shoulder surgeon during your consultation

Important areas to cover include whether surgery is the right choice for you at this time and what you can expect if you don’t choose to go ahead with surgery. You can also ask about the surgeon’s own experience, including success rates and possible complications.

  1. Is surgery my best option?
  2. Are my expectations from surgery realistic?
  3. What are the alternatives treatment options?
  4. If I delay surgery at this time, what are the implications in terms of function and pain?
  5. What is the recovery like after shoulder surgery?
  6. What complications can I expect after this surgery and how will these be managed?
  7. How many of these procedures have you performed and what are your success rates?
  8. Where will the operation be carried out?

To arrange a shoulder surgery consultation with the London Shoulder Specialists, call us on 020 3195 2442 or email Although all non-urgent / elective surgery bookings and appointments are postponed at the moment, we are still available for consultation either by telephone or video link.

Preparing for shoulder surgery

Preparing for shoulder surgery

As our nation’s healthcare resources are directed to handle the Coronavirus crisis, the result has meant a complete suspension of all private, elective surgery following the agreement formed last month between the NHS and the independent sector to reallocate the latter’s hospital capacity to NHS use.

The NHS has also understandably now cancelled all routine operations for the next three months, leaving many patients in limbo waiting to undergo much-needed surgery. However, even though there is now some uncertainty over when your shoulder operation may take place, it’s never too early to start ‘PreHabing’ before your operation.

PreHab encompasses all the same aspects of your post-surgery rehabilitation programme, touching on elements of nutrition, exercise and pain management, but you should embark on PreHab in advance of your surgery to ensure optimal recovery and the ultimate success of your procedure.

Ideally, you should have at least a few months pre-procedure to get in the best possible health. Some lifestyle factors that increase your surgical risk, such as smoking or being overweight, should be addressed as early as possible for you to experience the benefits.

1. Lose weight

The impact of carrying extra weight on your hip and knee joint is self-evident, but it can also cause shoulder pain, with normal range of motion diminished by nearly 40%, causing increased wear and tear.

A recent study also found that the higher the patient’s BMI, the more chance of post-surgical complications, including the need for revision surgery.

2. Quit smoking

 Stopping smoking in advance of rotator cuff tear or labral repair is probably one of the most important things you can do to improve your chances of surgical success – in fact, some believe that smoking may be the most important factor in your risk of developing complications after shoulder surgery, which can include infection, poor wound healing or less than satisfactory results.

This is supported by a number of studies, including a 2018 report into smoking and arthroscopic rotator cuff repair, published in the British Medical Journal Open Sport & Exercise Medicine, that found that although smokers will still benefit from surgery, they tend to present with larger tears and had a worse initial outcome and a lower functional improvement after surgery.

3. Address health concerns

 Not all shoulder surgery patients present with a secondary health condition, but diabetes can increase your risk of tendon damage, particularly rotator cuff tears. Tendon damage in type 1 and type 2 diabetes is the result of an accelerated production of advanced glycation end products (AGEs) that affect the structure of tendons and how they perform. Raised blood sugar levels can also affect your healing post-procedure, so addressing your diet during your PreHab can help you keep your blood sugar levels down.

 4. Start moving

 Although PreHab encompasses diet and other lifestyle factors, exercise is probably one of the most important aspects. Before any joint procedure, including shoulder surgery, improving the strength, flexibility and range of motion in the muscles that support the joint is essential. A quicker healing process post-procedure can be the direct result of the work you put in beforehand.

For more advice on how best to prepare for shoulder surgery, call us on 020 3195 2442 or email Although all non-urgent / elective surgery bookings and appointments are postponed at the moment, the London Shoulder Specialists are still available for consultation either by telephone or video link.