Rehab Protocol- Rotator Cuff Repair

Rotator Cuff Repair (Arthroscopic): This protocol is based on maintaining range of movement in the first phase and then gradually building strength in the middle to the last phase.

Pre-operative

ROM Exercises
Maximize shoulder strength of deltoid, intact rotator cuff muscles and scapular stabilizers.

First 3 weeks:

  • Patient education: movement limitations, posture, proper sling fitting, joint protection, and positioning
  • PROM shoulder flexion/abduction/ER/IR
  • Elbow/wrist/hand AROM w/ no resistance
  • Light active scapular strengthening exercises
  • Pendulum hangs
  • Modalities PRN(Modalities PRNrefers to “as needed” by the patient. Modalities at Harris Therapy include:*Hot Packs /Cold Packs *Transcutaneous Electric Nerve Stimulation or TENS*Electrical Stimulation*LASER)

Weeks 3-4 or 6 as tolerated

  • Progress scapular strengthening
  • Progress pendulum hangs to pendulum circles based on tolerance
  • Continue with PROM shoulder flex/abd/IR/ER
  • Joint mobilizations grades I and II for pain relief at GH/SC/AC/ST joints
  • Modalities PRN(Modalities PRNrefers to “as needed” by the patient. Modalities at Harris Therapy include:*Hot Packs /Cold Packs *Transcutaneous Electric Nerve Stimulation or TENS*Electrical Stimulation*LASER)

Weeks 6-12

  • Continue PROM as needed
  • Progress joint mobilizations at GH/SC/AC/ST joint to grades III and IV as needed
  • Initiate AAROM program and progress to AROM as tolerated
    • Pulleys, cane exercises, table slides, wall slides etc. in multiple planes
  • Posterior capsule stretching
  • Begin low-level closed chain shoulder exercises
  • Continue scapular strengthening/stabilization exercises
  • Initiate deltoid and non-repaired mm of RTC strengthening program when appropriate (pain-free and full AROM)
  • Modalities PRN(Modalities PRNrefers to “as needed” by the patient. Modalities at Harris Therapy include:*Hot Packs /Cold Packs *Transcutaneous Electric Nerve Stimulation or TENS*Electrical Stimulation*LASER)

Weeks 12

  • Initiate balanced progressive RTC strengthening program
  • Progress closed chain exercises
  • Ensure exercises are pain-free and are performed with no substitutions and adequate ROM
  • Dynamic scapular stabilization exercises
  • Exercises focusing on safe return to ADL's/work/recreational activities as tolerated
  • Upon discharge, ensure patient continues HEP for at least 6-8 weeks

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