RCR Rehab

Rotator Cuff Repair Rehabilitation Protocol for Steve A. Mora, MD

	Range of Motion	Sling	Therapeutic Exercises
Phase I 0-4 weeks	Passive ROM to tolerance. Maintain elbow at mid-axillary line while supine. Limit IR with arm at 90° abduction to 40° and behind back to T12.	Sling or abduction pillow for 4 wks at all times.	Codman's elbow/wrist/hand ROM, grip strengthening, isometric scapular stabilization. Scapular stretching. Pec minor stretch.
Phase II 4-8 weeks	4-6 wks: Gentle passive stretch to 140° FF, ER 40° at side, Abd 60°-80°, Increase IR at 90° to 60° and behind back to T7-T8. 6-8 wks: Increase ROM to tolerance	None	4-6 wks: Begin gentle active assistive active exercises, begin gentle joint mobs. 6-8 wks: Biceps* strengthening. Rotator cuff isometric strengthening at 12 wks. Cont Active ROM until wk 12.
Phase III 8-12 weeks	Progress to full motion	None	Scapular strengthening/stabilization, continue biceps, at 12 wks begin IR/ER Rotator Cuff isometrics, stretch post capsule when arm is warmed up.
Phase IV 12 weeks-5 months	Full without discomfort	None	Advance exercises. Begin sports-specific activities, maintain flexibility, increase velocity of motion, return to sports activities.**

*If biceps tenodesis is concomitantly performed, NO biceps strengthening until 8 weeks post-operatively.