REHABILITATION PROTOCOL:ARTHROSCOPIC ROTATOR CUFF REPAIR

Phase I (Weeks 0-4)

• Sling immobilization with supporting abduction pillow to be worn at all times except for showering and rehab under guidance of PT

• Range of Motion: True Passive Range of Motion Only to Patient Tolerance

• Goals: 140° Forward Flexion, 40° External Rotation with elbow at side, 60-80°Abduction without rotation, Limit Internal Rotation to 40°with the shoulder in the 60-80° abducted position

• Maintain elbow at or anterior to mid-axillary line when patient is supine

• Therapeutic Exercise – No canes or pulleys during this phase

• Codman Exercises/Pendulums

• Elbow/Wrist/Hand Range of Motion and Grip Strengthening

• Isometric Scapular Stabilization

• Heat/Ice before and after PT sessions

Phase II (Weeks 4-8)

• Discontinue sling immobilization

• Range of Motion

• 4-6 Weeks: Gentle passive stretch to reach ROM goals from Phase I

• 6-8 Weeks: Begin AAROM🡪AROM as tolerated

• Therapeutic Exercise

• 4-6 Weeks: Begin gentle AAROM exercises (supine position), gentle joint mobilizations (grades I and II), continue with Phase I exercises

• 6-8 Weeks: Progress to active exercises with resistance, shoulder flexion with trunk flexed to 45° in upright position, begin deltoid and biceps strengthening**

• Modalities per PT discretion

Phase III (Weeks 8-12)

• Range of Motion – Progress to full AROM without discomfort

• Therapeutic Exercise

• Continue with scapular strengthening

• Continue and progress with Phase II exercises

• Begin Internal/External Rotation Isometrics

• Stretch posterior capsule when arm is warmed-up

• Modalities per PT discretion

Phase IV (Months 3-6)

• Range of Motion – Full without discomfort

• Therapeutic Exercise – Advance Strengthening as tolerated: isometrics🡪therabands🡪light weights (1-5 lbs)

• 8-12 repetitions/2-3 sets for Rotator Cuff, Deltoid and Scapular Stabilizers

• Return to sports at 6 months if approved

• Modalities per PT discretion