Rotator Cuff Repair — Massive Rotator Cuff Repair

Mammoth Orthopedic Institute / Sierra Park PT · Timothy Crall MD; Brian B. Gilmer MD; Rachel Georgeson MPT

Weight-Bearing

N/A (shoulder) — sling per MD orders x6 weeks

Key Restrictions

Sling per MD x6 weeks; no shoulder AROM x6 weeks; PROM flexion/ABD in scapular plane; ER/IR limited to 30 deg in neutral x6 weeks; if subscapularis repair: limit ER to 30 deg (check op report); if tenodesis: no active biceps x6 weeks; no lifting >cup of water wks 6-12; no supporting body weight wks 6-12; no WB before wk 10; patient must demonstrate good GH/scapular mechanics before isotonic strengthening; plyometrics not until wk 20

Timeline & Phases

4 phases + return to activity: Phase I (0-6 wks, sling, PROM only, Codmans HEP, no AROM), Phase II (6-12 wks, PROM to full, AAROM, submaximal isometrics from wk 8, pulleys 8-10 wks), Phase III (12-16 wks, strength — high rep/low resistance 30 reps, scapular activation, prone exercises), Phase IV (16-22 wks, WB wall/prone, plyometric chest tosses wk 20+, body blade, bench press/lat pull-downs), Return to activity (22-26 wks, gradual return to work/recreation/sport, interval sport programs)

Notes

Subscapularis and tenodesis-specific precautions within protocol; high rep/low resistance emphasis (30 reps) Phase III; Rachel Georgeson MPT 2015; updated March 2017 by Crall MD and Gilmer MD; plyometrics from wk 20; interval sport programs (golf etc.) from wks 22-26; no return to overhead sport until Phase IV-V

Surgeon / Author

Timothy Crall MD; Brian B. Gilmer MD; Rachel Georgeson MPT

Published

2015 (updated March 2017)