Rotator Cuff Repair — Small to Large Rotator Cuff Repair

Mammoth Orthopedic Institute / Sierra Park PT · Timothy Crall MD (US Ski Team Physician); Bartlett White PA-C; Rachel Georgeson…

Weight-Bearing

N/A (shoulder) — sling per physician direction

Key Restrictions

Sling per MD; if tenodesis: no active biceps x6 weeks; if subscapularis repair: no IR/ER >30 deg x6 weeks; no lifting/AROM/overhead/body weight support Phase I-II; no push-ups or military press Phase V-VI; patient must demonstrate good GH/scapular mechanics before progressing to isotonic strengthening; WB exercises begin ~wk 12

Timeline & Phases

7 phases: Phase I (0-3 wks, PROM only, sling per MD, Codmans/table slides HEP), Phase II (3-6 wks, PROM full, submaximal isometrics at wks 5-6, rhythmic stabilization), Phase III (6-8 wks, DC sling at 6 wks, AAROM begins — UBE/GH seaters/wand/pulleys at wk 8), Phase IV (8-10 wks, AROM gravity-assisted progressing gravity-resisted, prone scapular strengthening), Phase V (10-12 wks, PNF/scaption/lateral raises, WB exercises begin ~wk 12, light swimming with kickboard), Phase VI (12-16 wks, full AROM without substitution, progress WB, functional activities, push-up progression wall to floor), Phase VII (16+ wks, full AROM with 2-5 lbs overhead, discharge to HEP)

Notes

References Brigham and Women's Hospital; Rachel Georgeson MPT 2015; approved by Gilmer MD 3/15/2017; 7-phase protocol; tenodesis and subscapularis-specific precautions; patient must demonstrate good mechanics before isotonic progression; no military press throughout; full AROM goal at wk 12; most detailed phase structure of Mammoth shoulder RCR protocols

Surgeon / Author

Timothy Crall MD (US Ski Team Physician); Bartlett White PA-C; Rachel Georgeson MPT

Published

2015 (approved by Gilmer MD 3/15/2017)