Shoulder and Elbow Surgeon


Complex Rotator Cuff Rehabilitation Protocol
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The aims of rehabilitation are to protect the repair in the early stages and to maximally optimise function in the long-term.

It is essential that the post op notes are checked for specific guidance to ensure appropriate rehabilitation.

General Points:
Do not push through pain – remember pain inhibits rotator cuff control.
Do not sacrifice quality of movement for range of movement.
Remember the patho-physiology of the repaired tendon is often degenerative and needs to be considered when progressing rehabilitation.

The patient is to wear a sling for 6 weeks. It can be removed to perform exercises as instructed by the physiotherapist.

Post Operative Instructions:

0-6 weeks:
Sling to be worn.
Hand, Wrist and Elbow exercises.
Pendular exercises.

Encourage optimal Scapulo-Thoracic position.

6-12 weeks:
Wean out of sling – light activities only.
Active assisted exercises with gradually increasing range of movement.
Consider short lever, supine closed kinetic chain exercises.
Active assisted elevation as comfort allows.

Anterior deltoid rehabilitation principles.

No long lever open chain exercises until 12 weeks

12-16 weeks:
Isometric exercises through available range of movement.
Continued deltoid rehabilitation principles.

16 weeks onwards:
Resisted movements through range and strengthening.

Functional Milestones and Activity Time scales:

Driving See general principles of rehabilitation
Swimming 16 weeks plus
Golf 16 weeks plus
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