Laderman et al (2024) Hydrotherapy after Rotator Cuff Repair Improves Short-Term Functional Results Compared with Land-Based Rehabilitation When the Immobilization Period Is Longer

Rotator cuff tears are a common musculoskeletal injury, often leading to pain, stiffness, and reduced shoulder function. This study compares the effectiveness of hydrotherapy and land-based therapy in patients undergoing rehabilitation after rotator cuff repair (RCR), focusing on early versus late initiation post-surgery.

The results show that late initiation of hydrotherapy significantly improved short-term functional outcomes compared to land-based therapy. At three months post-surgery, patients in the late hydrotherapy group achieved the highest Constant scores (70.3 ± 8.2), indicating better shoulder functionality. Early initiation of either therapy showed no significant advantage over the late protocols. However, the late hydrotherapy group also exhibited a higher risk of complications such as frozen shoulder or tendon retear.

Hydrotherapy benefits from water’s buoyancy and resistance, facilitating shoulder mobilization and reducing strain on repaired tendons. This makes it particularly effective in enhancing proprioception, range of motion, and muscular activation without overloading the surgical site.

While hydrotherapy offered superior short-term outcomes, there were no long-term differences in functional recovery between the hydrotherapy and land-based groups at 24 months. The study emphasizes the need for individualized rehabilitation plans that balance the benefits of enhanced short-term recovery with potential complication risks.