This protocol is intended to be a general outline only. The physician reserves the right to either advance or delay this protocol as deemed necessary. If so, this should be done by direct communication with the therapist, or in writing on the therapy referral form given to the patient on the day of surgery.

General Post-Operative Guidelines

  • For retracted, global, or massive tears (3 cm or greater) of the rotator cuff, physical therapy will begin at 2 weeks post-op for PROM ONLY to prevent capsular adhesions.  Patient to be seen 3x/week or as needed.
  • Patient will perform the following exercises as instructed by physician, starting on day of surgery: pendulum exercises, shoulder shrugs, elbow flexion/extension, and grip strengthening.  Patient may also begin walking and stationary bike for cardiovascular fitness.
  • For the first 6-8 weeks as per surgeon instruction, patient will wear sling with abduction wedge at all times except for bathing.  Sling can be removed for short periods with arm resting on couch/recliner armrest.
  • Patient will perform regular icing for control of pain and inflammation
  • No active AROM elevation of shoulder until at least 16 weeks post-op, or per surgeon recommendation


Subscapularis Repair Guidelines

Open Repair: Restrict ER PROM as follows:

  • 0-4 weeks: to neutral (0°)
  • 4-6 weeks: to 30°
  • 6-8 weeks: to 45°
  • 8-10 weeks: to 60°
  • 10-12 weeks: progress to full ROM (90°)

Scope Repair for partial tears: Restrict ER PROM as follows:

  • 0-4 weeks: to neutral (0°)
  • 4-6 weeks: to 45°
  • 6-8 weeks: to 90°
  • 8-10 weeks: progress to full ROM (90°)

No resisted IR isometric or IR anti-gravity AROM until at least Week 8 post-op.


Week 3-8: Patient seen 3x/week 

Goals by end of Week 8: PROM flexion to 140∞ supine, ER 60∞ supine w/arm abducted to 45∞, full scaption


  • No ER ROM beyond 45∞ for first 4 weeks.
  • No ER beyond 75∞ for first 8 weeks.
  • Continue wearing sling when out in public and during extended periods of walking.
  • Continue above exercises
  • Postural exercises: scapular retraction, scapular clock, etc.
  • Lawnmowers and table lifts
  • Scapular isometrics in sidelying
  • Initiate supine PROM for f