Rotator Cuff Repair (Small to Medium Tear)

Range Of Motion

• No PROM of shoulder for first 2 weeks
• ROM as tolerated for elbow, wrist and hand
• For Biceps Tenodesis:
  • No Active elbow flexion until 3 weeks (AAROM ok)

Sling

• Immobilized in sling with abduction pillow at all times, may be removed for exercises and showering. Wear sling at night.

Therapeutic Exercise

• NO Pendulums
• Cervical ROM
• Begin scapula musculature isometrics / sets
• Elbow, wrist, hand ROM
• Ball squeezes
• For Biceps Tenodesis:
  • No Active elbow flexion until 3 weeks (AAROM ok)

Range Of Motion

• Passive Forward Elevation (PFE): 60 degrees
• Passive External Rotation (PER) at 20° of abduction: 0°
• PER at 90° of abd: NA
• Active Forward Elevation (AFE): NA

Sling

• Immobilized in sling with abduction pillow at all times, may be removed for exercises and showering. Wear sling at night.

Therapeutic Exercise

• Codman’s Pendulums
• Therapist assisted Forward Elevation
• Supine passive ER stretches with broom handle
• Table slides
• Continue scapula musculature isometrics / sets
• Elbow, wrist, hand ROM
• Ball squeezes
• For Biceps Tenodesis:
  • No Active elbow flexion until 3 weeks (AAROM ok)

Range Of Motion

• PFE: 90°
• PER at 20° of abd: 20°
• PER at 90° of abd: NA
• AFE: NA

Sling

• Continue use of sling until end of Week 5
• Between Week 5 and 6 may wear sling for comfort only
• Discontinue sling at end of Week 6

Therapeutic Exercise

• Continue Phase I and II exercises
• Supine AAROM
• Pulley exercises
• Light scapular strengthening (retraction/protraction) , shoulder shrugs, scapular setting
• Gentle joint mobilization and soft tissue mobilization

Range Of Motion

6 WEEKS

• PFE: 90° - 120°
• PER at 20° of abd: 20° - 30°
• PER at 90° of abd: NA

AFE: NA

9 WEEKS

• PFE: 130° - 155°
• PER at 20° of abd: 30° - 45°
• PER at 90° of abd: 45°-60°

AFE: 80°-120°

12 WEEKS

• PFE: 140° - WNL
• PER at 20° of abd: 30° - WNL
• PER at 90° of abd: 75° - WNL

AFE: 120°-WNL

Sling

• None

Therapeutic Exercise

• Stretching, mobs, ROM exercises
• NO ROTATOR CUFF RESISTANCE EXERCISES
• Progress supine to seated to standing AAROM
• Progress pool based AAROM if available
• Begin unrestricted AROM against gravity at 9 weeks
• Towel Slide or horizontal dusting
• AAROM supine washcloth press-up
• AROM supine press-up
• Side-lying supported active elevation (on box or exercise ball)
• AROM reclined wedge press-up
• Supine elastic band Forward Elevation
• Aquatic Forward Elevation at slow speed

Range Of Motion

• Full ROM without discomfort

Sling

• None

Therapeutic Exercise

• Begin light theraband resistance exercises for the rotator cuff
• AROM or Resisted Pully Forward Elevation
• Incline Dusting
• Ball roll on wall
• FE with upright T-bar
• AAROM elevation
• Upright T-bar AAROM FE, active lowering
• Upright active FE with no weight
• Upright active FE 1 lbs.
• Aquatic FE fast speed
• Side-lying dumbbell ER at 0°, resistance of 25% of MVIC
• Elastic resistance ER, IR and forward punch
• Begin strengthening for lats, biceps/triceps, pecs, rhomboids, deltoids
• Progress with theraband exercises slowly to tolerance
• Begin to add sport and job specific activities

Range Of Motion

• Full ROM without discomfort

Sling

• None

Therapeutic Exercise

• Endurance
• High, middle and low scapular rows
• Standing dumbbell ER at 0° abd, 10-rep max
• Standing dumbbell ER in scapular plane, 10-rep max
• Elastic resistance shoulder flexion
• Elastic resistance throwing accelerate
• Elastic IR at 90°

Range Of Motion

• Full ROM without discomfort

Sling

• None

Therapeutic Exercise

• Strengthening
• Upright FE 3-4 lb, 10 rep max
• Side-lying dumbbell ER at 0°, 10-rep max
• Prone horizontal abd, 10-rep max
• Seated military press
• Elastic resistance ER at 90°
• Elastic resistance throwing decelerate
• Standing dumbbell ER at 90° abd, 10-rep max

• If cleared by Dr. Roth, may now be able to return to:
  • Weight Training
  • Skiing
  • Golf
  • Basketball
  • Manual Labor

Range Of Motion

• Full ROM without discomfort

Sling

• None

Therapeutic Exercise

• If cleared by Dr. Roth, may now be able to return to:
  • Throwing Sports
  • Tennis
  • Volleyball