You are here

Rotator Cuff Repair Rehab Protocol

 

Phase I –Protective Phase (0 to 6 weeks)

  • Abduction immobilizer / sling for 6 weeds with the arm in slight abduction (45° to 60°, promotes better blood flow to the supraspinatus, minimize tension on the repair), may take off to eat, shower, and to use arm for desk work.
  • NO ACTIVE SHOULDER motion for 6 weeks.
  • Active elbow, wrist and digit ROM – use putty.
  • Pendulum exercises.
  • Supine active assisted forward elevation (FE) to pain tolerance.
  • Once patient understands the difference between active and passive motion, the patient should start home passive FE with pulleys system.
  • Passive Forward elevation up to 140°.
  • Passive external rotation up to 40°.
  • Passive abduction to 75°.
  • Use modalities to control pain and swelling (i.e. ice, HVGS, TENS).
  • Home exercise program should be established so patient performs exercises 3-5 times per day.
  • Add active assisted IR behind back and shoulder extension (Wand, T-bar exercises, etc.) at 4 weeks.

Phase II – Intermediate phase (6 to 12 weeks)

  • Discontinue shoulder immobilizer.
  • Progess from active-assisted ROM to active ROM exercises.
  • Begin strengthening / resisted motion exercises at 12 weeks.
  • Forward elevation up to 160°.
  • External rotation up to 60°.
  • Abduction to 90°.

Phase III –Strengthening (10 to 24 weeks)

  • Full ROM.
  • Progressive Resistance Exercises.  Start light, progress as tolerated.
  • Wall pushups, press-ups.
  • Total Gym – rows, presses, pullovers. 
  • Rockwood exercises – flex, abd, ext, add, IR, ER, rows, presses.
  • Can use dumbbells or theraband tubing for Rockwood exercises.
  • Cybex strength testing – goal >85% of contralateral side at 20 weeks.
  • Start sport specific rehab.

Phase IV – Return to Activities (After 6 months)

  • Work on focal deficits.
  • Establish a home program.
  • Continue sport specific rehab.
  • Improvement continues for 12 months post op.

For Detailed Rehabilitation protocols see:

  • Brotzman SB, Clinical Orthopaedic Rehabilitation, Mosby, 2003

 

Disclaimer

The information on this website is intended for orthopaedic surgeons.  It is not intended for the general public. The information on this website may not be complete or accurate.  The eORIF website is not an authoritative reference for orthopaedic surgery or medicine and does not represent the "standard of care".  While the information on this site is about health care issues and sports medicine, it is not medical advice. People seeking specific medical advice or assistance should contact a board certified physician.  See Site Terms / Full Disclaimer