Shoulder Rehab Protocol Following Rotator Cuff Surgery

ROM Shoulder

After sustaining a tear of the shoulder rotator cuff musculature, the orthopedic surgeon post surgery must establish a shoulder rehab protocol. This will allow the patient to regain the loss of motion and strength without risking re-injury.

There is still some debate among orthopedic surgeons about the best protocol of rehabilitation following this delicate procedure. Most surgeon’s have agreed upon a  certain timeline that will ensure the most complete recovery.

Here we will take a look at that timeline as well as the physical therapy treatment that is implemented for patients to completely recover from rotator cuff surgery.

First Week

pendulumThe first week is an absolutely crucial time for both the surgeon and the patient. The shoulder rehab protocol here starts to use the muscles in the upper extremity almost immediately. Physical therapy exercises for this stage of recovery typically consists of shoulder pendulum, shoulder wheel and active elbow/wrist range of motion.

These active exercises are performed at least three times per day. When not performing these exercises the upper extremity must be supported by a sling or immobilizer. During this period ice applications should be applied to reduce swelling and bruising.


Two Weeks Post Surgery

Once the patient is able to perform active exercises of week one with minimal discomfort the next step of reconditioning can start.

theraband shoulder Beginning in the second week shoulder rehab protocol dictates that the patient should be started on passive and active assisted range of motion. The physical therapist will increase the range of motion slowly by performing it for the patient. Passive motion in this period is performed in certain planes of motion so healing is not disrupted.

Active assistive range of motion is performed by the patient using a pulley system or a wall to finger climb. For best results, these exercises exercises should be performed three times per week under the supervision of a qualified physical therapist. The sling is usually removed right after this period.

Four Weeks Following Surgery

After the success of the two week range of motion phase, the patient will move on to a phase of recovery that typically lasts between two through 6 weeks.

The shoulder rehab protocol for this period of time will tend to focus on the patient resuming a large degree of active daily routine with the involved upper extremity. Taking place during this time frame is light progressive resistive exercises focusing on high reps and low weight.  The patient can use resistive bands or an upper body ergometer in this period.

One of the most important aspects which a physical therapist will focus upon is proper usage of the repaired arm to decrease the likelihood of re-injury. Once the patient has exhibited proficiency in this stage they will move into the final stage of physical therapy. It is important to remember that this stage is based upon an individual’s recovery and is not tied to a specific time frame.

shoulder rehab pool

Final Phase

The final phase of the shoulder rehab protocol is entirely patient-driven. At this point in time the shoulder has recovered to such a degree that the individual no longer needs to have structured therapy and is encouraged to engage in an independent strengthening program. That is utilizing full-motion daily life activities as well as weight training using medium weight and high reps. At this point in recovery it is recommended the patient continue on a set program of resistance training and to keep in mind proper posture.

It is highly recommended after this surgical procedure that your shoulder rehab protocol be prepared by a licensed and qualified physical therapist for best results.