Rotator Cuff Repair Rehab Protocol (Standard)

Keys to a Successful Outcome

  • Do not push range of motion exercises early in therapy.  Moving the shoulder too far, too early, can disrupt the repair.

  • The rehabilitation process should not be too painful.  If it is, you may be doing too much.

  • Care should be taken to not place too much load on the repair.  It takes one year for the tendon to heal to the bone, and lifting too much before that time can disrupt the repair as well.  This is the most common mechanism of failure.

Phase
Brace
ROM
WB Status
Exercises
Weeks 0-4
Worn at all times*
None for weeks 0-2; can begin PROM; limit flexion to 90°, ER 45°, Ext 20°, ABD 45°, ABER 45°
NWB
Elbow/wrist ROM, grip strength, and pendulums at home only (weeks 0-2); begin PROM; posterior capsule mobilization; avoid stretch of anterior capsule and extension; closed chain scapula
Weeks 4-12
Worn during day only**
Begin AAROM/AROM; advance to flexion 140°, ABD 135°, ABER 90°, ABIR***
NWB
Begin AA exercises, deltoid/rotator cuff isometrics at 8 weeks; begin resistive exercises for scapular stabilizers, biceps, triceps, and rotator cuff****
Weeks 12-16
None
Gradual return to full AROM
NWB
Advance phase II; emphasize ER and lat eccentrics, glenohumeral stabilization; begin muscle endurance activites (upper body ergometer); cycling/running as tolerated at 12 weeks
Months 4-6**
None
FAROM
PWB
Aggressive scapular stabilization and eccentric strengthening; scapular perturbation; begin plyometric and throwing/racquet program, continue with endurance activities; maintain ROM and flexibility
Months 6-8
None
FAROM
PWB
Progress Phase IV activities, return to full activity as tolerated, no "heavy" lifting
Months 8-12
None
FAROM
WBAT
Full activity; no "heavy" lifting

 

*to be worn day and night; off for hygiene and exercises

**can discontinue completely 6 weeks from surgery

***If a distal clavicle excision is performed, horizontal adduction is restricted for 8 weeks post-op

****If a biceps tenodesis is performed, avoid active flexion of biceps and eccentric loads on biceps for 6 weeks post-op