Adhesive Capsulitis — LOA/MUA with Biceps Tenodesis and/or Small Rotator Cuff Repair

University of Virginia Orthopaedic Surgery

Weight-Bearing

NWB surgical UE

Key Restrictions

Sling determined by surgeon based on concomitant procedure: tenodesis = no sling or 4 weeks; RCR = sling 6 weeks; avoid resisted elbow flexion/forearm supination (tenodesis) initially; avoid IR/ER resistance (RCR) initially; no biceps loading until week 10; no sling beyond 6 weeks

Timeline & Phases

Phase I (Day 1-2 wks): sling per surgeon/procedure, AAROM with cane/pulleys to restore full PROM, avoid active elbow flex/supination (tenodesis) or IR/ER resistance (RCR), peri-scapular strengthening; Phase 2 (2-6 wks): maintain full PROM, gentle progressive AROM, shoulder isometrics to isotonics, peri-scapular exercises, discontinue sling at 4 or 6 wks per surgeon; Phase 3 (7-12 wks): restore full AROM/PROM, light resistive tubing/bands, prone I's/Y's/T's, resistive biceps loading at wk 10; Phase 4 (12+ wks): dynamic stabilization, progressive resistance (0.5 kg/10 days), NM control with D1/D2 patterns

Notes

Sling use depends on concomitant procedure (tenodesis vs RCR); early aggressive ROM like isolated LOA/MUA but with repair-specific restrictions layered on; avoid resistive biceps loading until week 10; resistance progression 0.5 kg/10 days; NM control with D1/D2 in Phase 4; 4 phases

Published

12/2024