Non-Operative Rotator Cuff — Non-Operative Massive Rotator Cuff Tear

Massachusetts General Hospital · MGH Sports Medicine

Weight-Bearing

Sling if recommended; avoid heavy lifting and overhead activities Phase I

Key Restrictions

Avoid heavy lifting and overhead activities; focus on anterior deltoid re-education and compensation; pain-guided progression throughout; outcomes vary compared to surgical intervention

Timeline & Phases

4 phases: Phase I (0-4 wks, protection/pain management — PROM/AAROM, ice, NSAIDs, injections as indicated), Phase II (4-8 wks, restoring ROM — anterior deltoid isometrics progressing to isotonics, scapular stabilization), Phase III (8-12 wks, progressive strengthening — remaining RC muscles, closed chain), Phase IV (12+ wks, return to function — activity-specific exercises)

Notes

Revised 8/2023; for massive RC tears not appropriate for surgery; anterior deltoid re-education is central strategy to compensate for absent cuff; multidisciplinary team recommended; outcomes inferior to surgical management. [Archived copy — original Massachusetts General Hospital URL retired in the Mass General Brigham site migration; Wayback snapshot 2026-06-13.]

Surgeon / Author

MGH Sports Medicine

Published

August 2023