Rotator Cuff Repair Rehab Protocol (Conservative)

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	Exercises
Weeks 0-6	Worn at all times*	None	NWB	Elbow/wrist ROM, grip strength, closed chain scapula; NO shoulder exercises
Weeks 6-12	Worn during day only**	Can begin PROM/AAROM; limit flexion to 90°, EXT 20°, ABD 45°, ABER 45°; begin AROM at week 8***	NWB	Continue closed chain scapula, posture, NO resistive exercises****
Weeks 12-16	None	Advance AAROM/AROM to flexion 140°, abd 135°, ABER 90°, gentle ABIR	NWB	Initiate resistive exercises, deltoid/rotator cuff isometrics at week 12; begin resistive exercises for scapular stabilizers, biceps, triceps, and rotator cuff**
Months 4-6	None	Gradual return to full AROM	PWB*	Advance phase III; emphasize ER and lat eccentrics, glenohumeral stabilization; begin muscle endurance activities (upper body ergometer); cycling/running as tolerated at 12 weeks
Months 6-8	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 8-12	None	FAROM	PWB*	Progress Phase V Activities, return to full activity as tolerated; no lifting more than 5lbs

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

**can discontinue 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