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 medium tears (1-3 cm) of the rotator cuff, physical therapy should begin between at 2 weeks post-op.
- 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 be allowed to begin activity such as stationery bike for cardiovascular fitness.
- For the first 4 weeks, patient will wear sling with abduction wedge at all times except for bathing. Abduction wedge can be removed at 4 weeks, with sling to be worn for all standing and walking activities for another 2 weeks.
- Patient will perform regular icing for pain and inflammation control.
Week 2 – 6: Patient seen 3x/week
Precautions: No AROM shoulder elevation for first 16 weeks.
ROM Guidelines: PROM flexion to 140° supine, full scaption.
ER to 55° w/arm abducted to 45° by end of Week 4.
ER to 65° w/arm abducted to 45° by end of Week 6.
- Continue above exercises
- Supine PROM for flexion, scaption, ER, and IR to belly
- Supine cane exercises for flexion
- Supine cane exercises for ER at 45° abduction
- Grade 1-2 glenohumeral joint mobilization, scapular isometrics in sidelying
- Soft tissue mobilization (parascapular, cervical) as indicated
- Postural exercises: scapular clock, retraction, depression, etc.
- Lawnmowers, “robbery,” and table lifts
- Pulley AAROM exercises in sitting for flexion and scaption
- Active IR with arm hanging at side in neutral position and elbow extended
Week 6-10: Patient seen 2x/week or as indicated
Precautions: No anti-gravity AROM
Goals by Week 8: Full supine PROM in all directions, IR to table