Rotator Cuff Repair Rehabilitation Program

PHASE I: 1-3 WEEKS POST-OP

Range Of Motion

  • No PROM of shoulder for first 3 weeks except pendulums
  • ROM as tolerated for elbow, wrist and hand
  • For Biceps Tenodesis:
    1. 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:
    1. No Active elbow flexion until 3 weeks (AAROM ok)

PHASE II: 3-4 WEEKS POST-OP

Range Of Motion

  • Restore shoulder ROM (as tolerated)
  • Strict therapist directed PROM only for flexion, abduction, external rotation, internal rotation
  • Goal full PROM by week 6
  • No therapist directed PROM for massive tears until 6 weeks.

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
  • Supine passive ER stretches with broom handle
  • Table slides
  • Continue scapula musculature isometrics / sets
  • Elbow, wrist, hand ROM
  • Ball squeezes
  • For Biceps Tenodesis:
    1. No Active elbow flexion until 3 weeks (AAROM ok)

PHASE III: 5-6 WEEKS POST-OP

Range Of Motion

  • Progress PROM
  • Pool Therapy if available for AAROM (pool is the assistance)
  • Goal full PROM by week 6
  • No therapist directed PROM for massive tears until 6 weeks.

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

  • Supine AAROM (Not until 6 weeks for massive RTC tear)
  • Pulley exercises
  • Light scapular strengthening (retraction/protraction) , shoulder shrugs, scapular setting
  • Gentle joint mobilization and soft tissue mobilization

PHASE IV: 6-12 WEEKS POST-OP

Range Of Motion

  • Progress to full ROM without discomfort

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

PHASE V: 12-24 WEEKS POST-OP

Range Of Motion

  • Full ROM without discomfort

Sling

  • None

Therapeutic Exercise

  • Begin light theraband resistance exercises for the rotator cuff (for massive tears, do not start resistance exercises until 18 weeks)
  • Begin strengthening for lats, biceps/triceps, pecs, rhomboids, deltoids
  • Progress with theraband exercises slowly to tolerance
  • Begin to add sport and job specific activities

PHASE VI: 6-8 MONTHS POST-OP

Range Of Motion

  • Full ROM without discomfort

Sling

  • None

Therapeutic Exercise

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

PHASE VII: 8+ MONTHS POST-OP

Range Of Motion

  • Full ROM without discomfort

Sling

  • None

Therapeutic Exercise

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

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