What is normal rehab for torn rotator cuff surgery?

[erom43]

My wife just had surgery for a torn rotator cuff and bone spurs. Her doctor had to reconnect tendons to the upper arm bone, so she is now restricted to a bound arm sling. He has told her not to use that arm in any way....not even the hand! Even told her that she would not be able to wash under that armpit for 4-6 weeks. My question is in reference to everything I have read on the web that mentions the importance of physical therapy during this first six weeks. Especially passive motion to keep scar tissue from forming and making it more difficult later on. She is not to even extend the arm at the elbow with upper arm locked to her side. Is this doctor being overly concerned with popping the tendon repairs to the extent that she will face additional problems in future rehab or even atrophy problems? I'd appreciate any insight anyone has to offer.
As a side note: my wife is taking hydrocodone which helps some with the pain, but gives her very strong headaches along with hallucinations. Are there any suggestions for this problem....other than adding ibuprofen for the headaches? Thanks.

[kaylee46]

i fell on my arm last night and my wrist is upward now and theres a tiney amount of swelling in my fingers do you think its broken? im in great pain also   from kaylee46

[erom43]

Thank you for your response.  That appears to be more in line with what I have read.  However, the restriction of any lower arm or even hand movement still does appear very conservative.  I am guessing that this doctor has had bad experiences with patients popping their sutures trying to use their hand or lower arm for everyday activities....even while in the sling.  Am I correct in assuming that the sutures should remain in tact if the upper arm remains immobilized against the upper torso?  Will it do any harm to extend the arm at the elbow if the upper arm remains still?  There is still some swelling in her hand as well.....is this normal?
As for the headaches, is there somthing in between oxycodone/hydrocodone and tylenol/advil that might produce pain relief without headaches?  Is Tramadol a possibility?  Thanks again Doctor.

[Dr_Veena]

Hi,
     Thanks for writing in. Surgical treatment for rotator cuff injuries can be in three forms. They are open repair, mini open repair and arthroscopic repair. Initial first two weeks immobilization is necessary for the newly placed sutures from being disrupted. But immobilization should not be for more than this period as this would lead to stiffness in the joint and permanent damage. Initial physical therapy is very mild, active lifting begins at 4-6 weeks. Physical therapy has to be continued for several months after surgery to expect complete recovery.
Follow the advise of your doctor and discuss the above mentioned possibilities.
Best.