Dr. Jeff Kimball, M.D. 

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POST-OPERATIVE ROTATOR CUFF REPAIR GUIDELINES

 

Postop

Goals

Precautions

Exercises

 

Weeks 0-2

HEP daily 

 

GOALS

Edema and pain control

Protect surgical repair

Wrist, hand, shoulder ROM

PRECAUTIONS

Splint 90° flexion at all times

No active supination

EXERCISES

Gentle wrist and hand ROM

Shoulder pendulum in splint

Shoulder PROM exercises 

 

Weeks 2-6

PT 1-2x/week

HEP daily

 

Edema and pain control Protect surgical repair

ROM 15-130° 

 

Brace locked at 90° 

Remove for shower & exercises  

No active elbow flexion

No active supination

 

Gradually increase elbow ROM: 

   Week 2: 45-100°

   Week 4: 30-115°

   Week 6: 15-130°

Active extension, passive flexion

Continue wrist, hand, shoulder ROM

Scapular strengthening

Gripping exercises

Triceps isometrics (week 5)

 

Weeks 6-12

PT 1-2x/week

HEP daily

 

Full ROM

Protect surgical repair

 

Weeks 6-8:

Open brace 20-120°

No active elbow flexion

 

Weeks 8-12:

DC brace

No lifting objects >1lb

 

Weeks 6-8: 

Full elbow ROM

Active extension, AA/P flexion

Continue wrist, hand, shoulder ROM

Begin cuff/deltoid isometrics 

 

Weeks 8-12: 

Begin biceps isometrics

Active flexion against gravity (week 8)

Resistive strengthening cuff/deltoid

Upper body ergometry (week 10)

 

Weeks 12-24

PT 1-2x/week

HEP daily

 

Improve strength

 

No brace

 

Weeks 12-16: 

ROM and stretching exercises

Elbow flexion resistive strengthening

 

Weeks 16-24: 

Progress strengthening as tolerated

Plyometrics and sport specific exercises

 

Weeks 24+

HEP daily

 

Return to play

Unrestricted activity

 

Return to sport (MD directed)

 

Maintain ROM and strength