Kathryn H. Hanna, MD
Rotator Cuff Repair Protocol
Ultra sling to be worn at all times x 6 wks
Phase 1 (0-2weeks):
1. Aerobic
a. Stationary bike x 30 min
b. Easy walking on level surface x 30 mins
2. Range of Motion
a. No shoulder shrugs with ROM
b. Passive forward flexion and abduction to 90 degrees
c. Passive external rotation < 45 and internal rotation < 30
d. Active wrist range of motion
e. Codman exercises at least 3 times a day x 5-10 mins in sling
3. Strength
a. Wrist and grip only
b. No pulleys until 6 wks
c. Shoulder shrugs, shoulder pinches/scapular retraction
4. Modalities
a. IFC & ice x 20 mins
5. Goals
a. Pain free passive range of motion to limitations above
Phase 2 (2-4 weeks):
1. Aerobic
a. Same as above, progress to 60 mins
2. Range of motion
a. Progress passive forward flexion to 150, scapular plane 140, abduction 120
b. External < 60 and internal rotation <45
c. Start active assisted range of motion to limits above
3. Strength
a. Start gentle isometric exercises
4. Goals
a. Passive ROM to limits above
Phase 3 (4-6 wks):
1. Aerobic
a. Same as above
2. Range of Motion
a. Progress to full passive ROM
b. Progress active assisted ROM to full
3. Strength
a. Begin isometrics
4. Goals
a. Full passive ROM by 6 wks
Phase 4 (6-12 weeks):
1. Aerobic
a. May start elliptical, treadmill at incline and progress to walk run x 30 mins
b. Start Upper Body Exercise w/o resistance
2. ROM
a. Start active range of motion (no shoulder shrugging)
3. Strength
a. Begin rotator cuff strengthening
b. Begin light therabands
c. Start body blade at neutral
d. Posture control
e. Begin push-up progression
4. Goals
a. Full range of motion
b. 4/5 strength (rotator cuff and scapula stabilization)
Phase 5 (12 wks-18 wks)
1. Aerobic
a. Continue progression to running on treadmill
b. Rowing machine
c. Versiclimber
2. ROM
a. Continue to full ROM
3. Strength
a. Progress pushups
b. Body blade at multiple angles
c. Unrestricted therabands in all planes
d. Continue rotator cuff strengthening
4. Goals
a. Full range of motion
b. Full strength
c. Normal pushups by week 16
d. Sport specific training at week 16
e. Start throwing program at week 16
Phase 6 (>18wks):
1. Goals
a. Pushups, pull-ups, full sports at 6 months
b. Able to pass PRT/PFT
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