Rehabilitation following Rotator Cuff Repairs
It is important to follow operation details and post operative instructions from your surgeon.
Immediate Post operative Recovery
Usually discharged same day
Arm immobilised in a sling for 6 weeks including night-time
You will be shown how to put your sling on and off
Stitches on the skin to come out at 10 – 14 days
Keep the wound site dry until the wounds have healed
Take your painkillers regularly and use ICE to assist with pain and swelling
Maintain good under-arm hygiene while in the sling
Summary of key milestones
Dressings and stitches removed 10 - 14 days post ops
Sling for up to 6 weeks
Swimming - 8 weeks for breaststroke
Driving approx. 8 weeks
Golf – 3 months
Contact sport - 4 - 6 months
Strength training 12 weeks
Manual work – 4 – 6 months
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Phase I: Week 0 – 3
Goals
Minimise pain and swelling
Regularly use ice therapy
Protect repaired rotator cuff tendon
Keep wound areas clean and dry
Restrictions
Lifting of objects
Supporting of body weight with hand
Avoid shoulder ER past 40 degrees and shoulder extension beyond neutral
Supporting your body weight into your hands
Sudden jerking or excess shoulder movements
Reaching overhead and behind your back
Pushing or pulling
Interventions
Wear your sling regularly including bedtime as directed by surgeon Postural awareness
Ball squeezes
AROM - Active Range of Motion of elbow, neck and wrist
Elbow, neck, and wrist range of movement exercises
Passive external rotation
Pendular exercises
Posture awareness
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Phase II: 3 – 6 weeks
Continue elbow, neck, and wrist range of movement exercises.
Goals
Some Important Milestones
90 degrees shoulder PROM - Passive Range of Motion forward elevation
20 degrees shoulder PROM ER - External Rotation in scapular plane
0 degrees of shoulder PROM IR - Internal Rotation in the scapular plane
Minimal substitution patterns with AAROM - Active Assisted Range of Motion
Pain < 4/10
No complications with Phase II
Restrictions
Lifting of objects
Supporting of body weight with hand
Bimanual activities
Sudden jerking or excess shoulder movements
Reaching overhead and behind your back
Pushing or pulling
Interventions
Start PROM - Passive Range of Motion
Flexion
Abduction in the scapular plane
ER - External Rotation in scapular plane
IR - Internal Rotation in scapular plane
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Phase III (6 – 12 weeks)
AROM - Active Range of Motion
PROM - Passive Range of Motion
ER - External Rotation
IR - Internal Rotation
Goals
Continue PROM - Passive Range of Motion
Introduce active-assisted range of motion such as the use of pulleys and canes
Improve neuromuscular control and strength
Minimise pain and inflammation
Exercises
155 degrees shoulder PROM forward elevation
45 degrees shoulder PROM ER and IR in scapular plane
60 degrees shoulder PROM ER @ 90 ABD
120 degrees shoulder AROM elevation
Minimal to no substitution patterns with shoulder AROM
Perform all exercises demonstrating symmetric scapular mechanics
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Phase IV (12 - 18 weeks)
Goals
Aim for full PROM without pain
Optimising neuromuscular control
Improving endurance