Mehul R Shah, M.D. - Orthopaedic Surgeon - New York Hospital for Joint Diseases - NYU LANGONE MEDICAL CENTER
Mehul R Shah, M.D. - Orthopaedic Surgeon - New York, NY: 212-598-3897, 646-501-7067 - Lake Success, NY: 516-467-8600
Mehul R Shah, M.D. - Orthopaedic Surgeon
Mehul R Shah, M.D. - Orthopaedic Surgeon
Patient Info

Rotator Cuff Repair Rehab Protocol

Phase 1 Protective Phase (0-6 Weeks)

Goals

  • Gradual increase in ROM
  • Increase shoulder strength
  • Decrease pain and inflammation

0-3 Weeks

  • Fit brace or sling (physician determines)
  • Begin pendulum exercises
  • Perform active-assisted ROM exercises (L-bar exercise):
    • Flexion to 125 degrees
    • ER/IR (shoulder at 40 degrees abduction) to 30 degrees
  • Perform passive ROM to tolerance
  • Use rope and pulley-flexion
  • Perform elbow-ROM and hand-gripping-exercises
  • Begin sub-maximal isometrics:
    • Flexors
    • Abductors
    • ER/IR
    • Elbow flexors
  • Use ice and pain modalities

3-6 Weeks

  • Discontinue brace or sling @6wks
  • Continue all exercises listed above
  • Performed active-assisted ROM exercises:
    • Flexion to 145 degrees
    • ER/IR (performed at 65 degrees abduction) range to tolerance

Phase 2 Intermediate Phase (7-14 Weeks)

Goals

  • Full, non-painful ROM (10 Weeks)
  • Gradual increase in strength
  • Decrease pain

7-10 Weeks

  • Perform active-assisted ROM L-bar exercises:
    • Flexion to 160 degrees
    • ER/IR (performed at 90 degrees shoulder abduction) to tolerance
      (greater than 45 degrees)
  • Perform strengthening exercises:
    • Use exercise tubing ER/IR, arm at side
    • Initiate humeral head stabilizing exercise
    • Initiate dumbbell-strengthening exercises, for the following:
      • Deltoid
      • Supraspinatus
      • Elbow flexion/extension
      • Scapular muscles

10-14 Weeks

  • Continue all exercises listed above (full ROM by 10-12 Weeks)
  • Begin isokinetic strengthening (scapular plane)
  • Begin side-lying ER/IR exercises (dumbbell)
  • Begin neuromuscular control exercises for scapula
    Note: Patient must be able to elevate arm without shoulder and scapular hiking before initiating isotonics; if unable, maintain on humeral head stabilizing exercises

Phase 3 Advanced Strengthening Phase (15-26 Weeks)

Goals

  • Maintain full, non-painful ROM
  • Improve strength of shoulder
  • Improve neuromuscular control
  • Gradual return to functional activities

15-20 Weeks

  • Continue active-assisted ROM exercise with L-bar:
    • Flexion, ER, IR
  • Perform self-capsular stretches
  • Begin aggressive strengthening program:
    • Shoulder flexion
    • Shoulder abduction (to 90 degrees)
    • Supraspinatus
    • ER/IR
    • Elbow flexors/extensors
    • Scapular Muscles
  • Begin interval sports program

21-26 Weeks

  • Continue all exercises listed above
  • Use isokinetic test (modified neutral position) for ER/IR at 180 and 300 degrees per second
  • Begin interval sport program

Phase 4 Return to activity Phase (24-28 Weeks)

Goals

  • Gradual return to recreational sport activities

24-28 Weeks

  • Continue all strengthening exercises
  • Continue all flexibility exercises
  • Continue progression on interval programs.

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