Rotator Cuff Repair Protocol

Phase 1: PROTECTIVE PHASE (Weeks 0-8)

Goals:

  • Protect integrity of the repair
  • Decrease pain and inflammation
  • Gradually increase in ROM
  • Retard muscle atrophy

Early Protective Phase (0-6 Weeks):

  • Pendulums
  • Scapular Isometrics (primary retraction)
  • Elbow, Wrist, Hand AROM
  • PROM to tolerance
  • Modalities as needed

Late Protective Phase (6-8 Weeks)

  • Continue previous exercises
  • Initiate AAROM exercises progressing to AROM as tolerated
  • Shoulder Sub-Maximal Isometrics
  • PROM to tolerance
  • Modalities as needed

(Patient must be able to elevate arm without shoulder and scapular hiking before initiating standing AROM; if unable, continue with supine exercises).

PHASE 2: EARLY STRENGTHENING PHASE (Weeks 8-10)

Goals:

  • Decrease pain and inflammation
  • Restore full PROM and AROM
  • Gradual increase in strength

Early Strengthening Phase

  • Continue PROM as needed to achieve and maintain full ROM
  • Initiate rhythmic stabilization exercises
  • Strengthening exercises for the hand, wrist, elbow and scapular musculature
  • Initiate gentle strengthening
  • Modalities as needed

Expectations:

  • 10-12 weeks - Patient should have achieved full active and passive ROM
  • 12-16 weeks – Patient should be nearing normal strength and full ROM

Early Advanced Strengthening Phase (Weeks 10-12)

  • Continue exercises above
  • Advance strengthening exercises including empty can as tolerated
  • General conditioning program

Late Advanced Strengthening Phase (Weeks 12-Discharge)

  • Continue all strengthening exercises
  • Continue all flexibility exercises
  • Gradual progression of functional activities per patient needs