Rehab Protocol- Rotator Cuff Repair

Rotator Cuff Repair (Arthroscopic): This protocol is based on maintaining a 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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