Rotator cuff repair >2cm

This protocol is based on maintaining range of movement in the first phase and then gradually building strength in the middle to the last phase.

Pre-op

  • ROM Exercises
  • Maximise shoulder strength of deltoid, intact cuff muscles and scapula stabilisers.

Day 1 - 3 weeks

  • Mastersling with body belt
  • Wrist/hand/finger exercises
  • Elbow flex/ext, pro/supination
  • Shoulder girdle exercises
  • Scapula setting exercises
  • Pendular exercises
  • Passive ROM in all directions as tolerated
  • Mobility stage 1 

3-6 weeks:

  • Do not force or stretch
  • Gentle isometric exercises in neutral as pain allows
  • Wean off sling
  • Begin active assisted exercises ensuring glenohumeral movement, not scapulothoracic.
  • Mobility Stage 2 

6 weeks +:

Milestones

 

4 Weeks

> 50% pre op passive ROM

6 Weeks

Active assisted ROM equal to pre op level

12 Weeks

Active ROM equal to pre op level

Return to functional activities

Driving                        6 Weeks

 Swimming                  Breaststroke:   6 weeks

                                    Freestyle:          3 months

 Golf                             3 Months

 Lifting                         3 Months (Then guided by the strength of the individual patient)

 Return to work          Sedentary job: 3 weeks  

                                    Manual job:      Guided by Surgeon