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Arthroscopic Rotator Cuff Repair(RTC) Rehab

You have had an arthroscopic rotator cuff repair and therefore the rehabilitation is significantly different from patients that have had an open or mini-open procedure. Studies have shown that early motion after an arthroscopic rotator cuff repair does not improve motion at one year and in fact may increase the likelihood of early failure. Healing is a biologic process that must be respected and cannot be rushed. Please follow the instructions below for a successful outcome. Be prepared to work hard and be patient.

Phase I - Immediate Post-Surgical Phase (Days 1 - 14)

Goals:

  • Maintain integrity of the repair
  • Diminish pain and inflammation
  • Prevent muscular inhibition

Days 1-14

  • Sling
  • Pendulum exercises 4x daily (flexion, circles)
  • Elbow/hand gripping & ROM exercises
  • Cryotherapy/Ice for pain and inflammation - 15-20 minutes every hour
  • Sleeping - sleep in sling or brace

Precautions to be maintained through Week 6:

  • Maintain arm in brace, remove only for exercise
  • No lifting of objects
  • No excessive shoulder extension
  • No excessive or aggressive stretching or sudden movements
  • No supporting of body weight by hands
  • No bimanual activities (pulling on pants/socks, etc.)

Phase II - Protection Phase (Weeks 3 - 6)

Goals:

  • Allow healing of soft tissue
  • Do not overstress healing tissue
  • Decrease pain & inflammation

Weeks 3-6

  • Continue pendulum exercises
  • Continue use of cryotherapy/ice as needed if still swollen
  • Start formal PT around week 4 - 6 beginning with PROM up until week 6
  • No Active-Assisted ROM(AAROM), or active ROM(AROM)

Phase III - Intermediate Phase (Weeks 7 - 15)

Goals:

  • Obtain full ROM
  • Dynamic shoulder stability

Weeks 7-10

  • PROM (as needed to obtain full ROM)
  • Start AAROM exercises (ie. pulleys, etc)
  • Work on scapulo-humeral rhythm, peri-scapular strengthening(no push-ups plus)
  • May use arm for light activities of daily living(ADL's)
  • May begin gentle AROM

Weeks 11-15

  • Continue AROM exercises as tolerated and begin RTC strengthening

Phase IV - Advanced Strengthening Phase (Weeks 16 - 23)

Goals:

  • Maintain full non-painful ROM
  • Enhance functional use of upper extremity
  • Improve muscular strength & power
  • Gradual return to functional activities

Weeks 16-19

  • Continue ROM & stretching to maintain full ROM
  • Self capsular stretches
  • Progress shoulder strengthening exercises

Weeks 20-23

  • Continue all exercises listed above
  • Continue to perform ROM stretching, if motion is not complete

Phase V - Return to Activity Phase (Weeks 24+)

Goals:

  • Gradual return to strenuous work activities
  • Gradual return to recreational sport activities

Week 24

  • Continue stretching, if motion is tight
  • May initiate interval sport program (i.e., golf, etc)

Please use the link provided to learn more about arthroscopic rotator cuff repair (RTC) rehabilitation.

Download Arthroscopic Rotator Cuff Repair (RTC) Rehabilitation (PDF)