Rotator Cuff Repair Rehabilitation Protocols

41 Rotator Cuff Repair rehabilitation protocols from 23 institutions, published 2009–2025. Weight-bearing progressions vary by institution — compare them in the table below before selecting a protocol.

Institution	Weight-Bearing	Key Restrictions
Dr. Michael C. Fu MD (Hospital for Special Surgery)	N/A	Sling with abduction pillow; small/medium: PROM starts wk 2 (elevation to 90, ER to 30); large/massive: PROM…
Dr. Michael C. Fu MD (Hospital for Special Surgery)…	N/A	Sling 10 days; no rotation at 90 abduction until 4 wks; no abduction or 90/90 ER until 6 wks; if DCE: hold…
Gundersen Health System (GLSM) — Small to Medium Tears (<1–4…	Sling 24 hrs/day x 4-6 wks; remove for bathing/dressing/exercises; keep arm relaxed in…	No AROM or resisted ROM Phase I (wks 0-4); no IR or extension initially — all PROM starts in scapular plane…
iOrtho — Large to Massive Tears	Sling day and night with abduction pillow (30-45 deg) wks 1-6; gradually removed wks 6-10…	Same restrictions as small-medium RCR; subscapularis repair: no ER >0 deg, no ABD >90 deg in Phase I; more…
iOrtho — Small to Medium Tears	Sling day and night with abduction pillow (30-45 deg) wks 1-6; gradually removed wks 6-10…	No AROM or PROM shoulder wks 1-6; no WB; no reaching overhead or behind back; no pushing/pulling; no AROM…
Lahey Hospital & Medical Center — Massive Rotator Cuff Repair…	N/A	Abduction sling until wk 6; no AAROM or pendulums wks 0-7; no rotator cuff strengthening until 12 wks; no…
Lahey Hospital & Medical Center — Small to Moderate Rotator…	N/A	Abduction sling until wk 6; no active motion beyond hand-to-mouth; no lifting objects; no arm behind back…
Mammoth Orthopedic Institute / Sierra Park PT — Massive…	N/A (shoulder) — sling per MD orders x6 weeks	Sling per MD x6 weeks; no shoulder AROM x6 weeks; PROM flexion/ABD in scapular plane; ER/IR limited to 30 deg…
Mammoth Orthopedic Institute / Sierra Park PT — Small to…	N/A (shoulder) — sling per physician direction	Sling per MD; if tenodesis: no active biceps x6 weeks; if subscapularis repair: no IR/ER >30 deg x6 weeks; no…
Massachusetts General Hospital — Isolated Subscapularis Repair	Sling day and night x 4 wks; discontinue sling Phase II (wk 4-8)	ER limited to 30 deg (no forceful motion) Phase I; IR limited to belt line Phase I; ABD limited to 90 deg…
Massachusetts General Hospital — Large to Massive Tears (>3…	Sling with abduction pillow (30-45 deg) day and night x 6 wks; PROM begins at wk 6 (not…	6-week period of full immobilization — NO PROM of shoulder Phase I (wks 1-6); only hand/wrist/elbow AROM (no…
Massachusetts General Hospital — Small to Medium Tears (≤3 cm)	Sling in neutral rotation with abduction pillow (30-45 deg); use at night through Phase…	No shoulder AROM/AAROM Phase I; no lifting Phase I-II; no supporting body weight; PROM ER ≤20 deg scapular…
Mountain Orthopaedics — Arthroscopic and Open Rotator Cuff…	N/A; sling and swathe full time wks 1-6; sling daytime / swathe for sleep wks 5-6…	No active shoulder motion until wk 5-6; no lifting with operative hand until wk 6-8; avoid full cuff stress 4…
Nebraska Orthopaedic Center — Massive Tears (>5 cm) / Type…	Shoulder immobilizer x 8 wks (worn at all times except ROM exercises; D/C completely at…	Massive defined as >5 cm; immobilizer 8 full weeks; no PROM until wk 2-6 phase; no active motion x 8 wks; no…
NYU Langone Health	N/A	Sling w/ abduction pillow 24/7 x6 wks; no weight bearing 0-6 wks; no cross-body adduction or IR up back 0-6…
Ohio State University Wexner Medical Center — Large to…	Sling 6 wks (vs 4-6 wks for small-medium); PT starts at wks 4-6	Large 3-5 cm; massive >5 cm; subscapularis repair (12 wks): no ER >30 deg, no cross-body ADD, no active IR or…
Ohio State University Wexner Medical Center — Small to Medium…	Sling 4-6 wks; D/C sling per physician Phase 2; PT starts at wk 2	Small <1 cm; medium 1-3 cm; no AROM before 6 wks; avoid scapular substitution with AA/AROM; no behind back…
Orthopaedic Associates of Maine — Large Tear	FWB; sling/swathe at all times wks 0-6 (except bathing/sitting from wk 2); sling for…	PROM limits wks 0-6: 90° pure abd, 20° ext, 70° IR (not behind back); avoid subscapularis activation until…
Orthopaedic Associates of Maine — Medium Tear	FWB; sling full time wks 0-4 (except bathing/exercises); sling for comfort daytime wks…	PROM limits wks 0-2: 90° pure abd, 20° ext, 70° IR (not behind back); subscapularis repair: limit ER to 0°…
Orthopaedic Associates of Maine — Small Tear	FWB; sling full time wks 0-4 (except bathing/exercises); sling for comfort wks 4-6 or in…	Sling full time until wk 4; sling for comfort wks 4-6; no shoulder flexion isometrics wks 2-6; no UBE until…
Orthopedic & Sports Medicine Specialists (OSMS) — Massive…	Sling with limited removal in safe environments at 10-14 days Phase I; sling fully…	True PROM only Phase I (no canes/pulleys — active-assist not allowed); if subscapularis repaired…
Orthopedic & Sports Medicine Specialists (OSMS) — Small to…	Sling with limited removal in safe environments at 10-14 days Phase I; sling fully…	True PROM only Phase I (no canes/pulleys); if subscapularis repaired concomitantly limit ER to 30 deg, no…
Samaritan Athletic Medicine (SAM Health, Corvallis OR)…	N/A (upper extremity)	Sling at all times until PT-cleared; NO shoulder mobility (wrist/hand/elbow only) for first 4 wks; wks 4-8…
Samaritan Athletic Medicine (SAM Health, Corvallis OR)…	N/A (upper extremity)	Sling at all times until PT-cleared; no active UE movement Phase I-II; PROM only: flexion <=120 deg Phase I /…
Sanford Health — Rotator Cuff Repair — Large to Massive Tears	N/A – upper extremity	No AROM x 0-8 wks; immobilization 6-8 wks; AROM at 8 wks; strengthening at 12 wks; subscapularis repair: ER…
Sanford Health — Rotator Cuff Repair — Small to Medium Tears	N/A – upper extremity	No AROM x 0-6 wks; no movements beyond neutral extension; no reaching behind back; no…
SOMOS (Society of Military Orthopaedic Surgeons)	N/A (Upper Extremity)	Sling per tear size: small 4 wks, medium 6 wks, large/massive 6-8 wks; PROM immediate for small/medium only…
Sutter Health / Palo Alto Medical Foundation — Large to…	N/A (upper extremity)	Sling with abduction pillow at all times wks 1-6 (remove for exercises/showering); no AROM Phase I (1-6 wks)…
Sutter Health / Palo Alto Medical Foundation — Small to…	N/A (upper extremity)	Sling with abduction pillow at all times wks 1-5 (comfort only wks 5-6; D/C wk 6); PROM Phase I (wks 1-2)…
The Steadman Clinic — Arthroscopic Rotator Cuff Repair	Abduction sling/brace full time weeks 1-4; comfort only weeks 4-6; D/C end of week 6	No AROM weeks 1-6; no lifting; no shoulder motion behind back; no sudden movements; no supporting body…
UCLA Department of Orthopaedic Surgery - Sports Medicine	N/A (upper extremity)	Sling with or without abduction pillow as directed by MD; no active ROM on land Phase 1; PROM: elevation…
UCLA Department of Orthopaedic Surgery - Sports Medicine…	N/A (upper extremity)	Sling with abduction pillow at all times including sleep; sling removed for grooming/exercise; removed for…
UCLA Department of Orthopaedic Surgery - Sports Medicine…	N/A (upper extremity)	Sling with or without abduction pillow as directed; NO pendulum exercises; no active ROM x 8 wks; PROM Phase…
University of Delaware Physical Therapy — Large Tear, No…	Sling with ABD pillow 24 hrs/day weeks 1-2; sling (D/C ABD pillow) weeks 3-5; D/C sling…	No IR behind the back; no heavy resisted flexion for 6 weeks; no resisted ABD for 8 weeks; no resisted ER for…
University of Delaware Physical Therapy — Large Tear with…	Sling with ABD pillow 24 hrs/day weeks 1-3; sling (D/C ABD pillow) weeks 4-6; D/C sling…	No IR behind the back; no heavy resisted flexion for 6 weeks; no resisted ABD for 8-12 weeks; no resisted ER…
University of Delaware Physical Therapy — Small Tear, No…	Sling 24 hrs/day week 1; sling in crowds weeks 2-4; D/C sling weeks 5-8	No IR behind the back (towel stretch); no resisted ABD for 8 weeks; no heavy resisted flexion for 6 weeks…
University of Delaware Physical Therapy — Small Tear with…	Sling with abduction pillow 24 hrs/day weeks 1-2; sling only (no ABD pillow) weeks 3-5…	No IR behind the back (towel stretch); no resisted ABD for 8 weeks; no heavy resisted flexion for 6 weeks…
University of New Mexico (UNM) Sports Medicine	N/A (upper extremity)	Sling duration surgeon-determined (2, 4, or 6 weeks); if concurrent biceps tenodesis: no resisted elbow…
University of Virginia Orthopaedic Surgery	NWB surgical UE; abduction pillow brace/sling for 6 weeks	Abduction pillow brace/sling for 6 weeks; PT typically not started until 2-week post-op visit; PROM only for…
University Orthopedics (Brown University)	N/A (upper extremity)	Immobilizer with abductor pillow x 4-6 weeks (including sleep); no IR behind back if subscapularis repair; no…
UW Health Sports Medicine — (Type I and Type II) and Isolated…	N/A (shoulder surgery)	Type I: sling 4-8 weeks, no AROM, no active abduction 8 weeks, no supraspinatus resistance 12 weeks. Type II…

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