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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