SPORTS MEDICINE  ·  SURGERY OF THE KNEE  ·  SURGERY OF THE SHOULDER  

Rotator Cuff Rehabilitation Print

Post Surgical Rehabilitation Protocol, Type Two - Rotator Cuff Repair (Deltoid Splitting), Medium to Large Tear - Greater than 1 cm and Less than 5 c.

Post Surgical Rehabilitation Protocol 

Type Two - Rotator Cuff Repair (Deltoid Splitting)

Medium to Large Tear - Greater than 1 cm and Less than 5 c

I. Phase One - Protection Phase (Week 0-6)

Goals:

(1) Gradual increase in ROM

(2) Increase shoulder strength

(3) Decrease pain and inflammation

A. Week 0-3

1. Brace or sling (physician determines)

2. Pendulum exercises

3. Active assisted ROM exercises (L-bar exercises)

a. Flexion to 125 degrees

b. ER/IR (shoulder at 40 degrees abduction) to 30 degrees

4. Passive ROM to tolerance

5. Rope and pulley flexion.

6. Elbow ROM and hand gripping exercises

7. Submaximal isometrics

a. Flexors

b. Abductors

c. ER/IR

d. Elbow flexors

8. Ice and pain modalities

B. Week 3-6

1. Discontinue brace or sling

2. Continue all exercises listed above

3. AAROM exercises

a. Flexion to 145 degrees

b. ER/IR (performed at 65 degrees abduction) range to tolerance

II. Phase Two - Intermediate Phase (Week 7-14)

Goals:

lt;p style="padding-left: 30px;">(1) Full, onon-painful ROM (Week 10)

(2) Gradual increase in strength

(3) Decrease pain

A. Week 7-10

1. AAROM L-bar exercises

a. Flexion to 160 degrees

b. ER/IR (performed at 90 degrees shoulder abduction) to tolerance (> 45 degrees)

2. Strengthening exercises

a. Exercises tubing ER/IR (arm at side)

b. Initiate humeral head stabilizing exercise

c. Initiate dumbbell strengthening exercises

- Deltoid

- Supraspinatus

- Elbow flexion/extension

- Scapulae muscles

B. Week 10-14 (full range of motion desired by Week 10-12)

1. Continue all exercises listed above.

2. Initiate isokinetic strengthening (scapulae plane)

3. Initiate sidelying ER/IR strengthening exercises

4. Initiate neuromuscular control exercises for scapular

*Patient must be able to elevate arm without shoulder and scapular hiking before initiating isotonics; if unable, maintain on humeral head stabilizing exercises

III. Phase Three - Advanced Strengthening Phase (Week 15-26) 

Goals:

(1) Maintain full non-painful ROM

(2) Improve strength of shoulder

(3) Improve neuromuscular control

(4) Gradual return to functional activities

A. Week 15-20

1. Continue AAROM exercises with L-bar

- Flexion, ER, IR

2. Self capsular stretches

3. Aggressive strengthening program

a. Shoulder flexion

b. Shoulder abduction (to 90 degrees)

c. Supraspinatus

d. ER/IR

e. Elbow flexors/extensors

f. Scapula strengthening

4. Conditioning program

B. Week 21-26

1. Continue all exercises listed above

IV. Phase IV - Return to Activity Phase (Week 24-28)

A. Week 24-28

1. Continue all strengthening exercises

2. Continue all flexibility exercises

3. Continue progression on interval programs

 
© Allen F. Anderson, M.D. 2017