Rotator Cuff Repair — Isolated Subscapularis Repair

Massachusetts General Hospital · MGH Sports Medicine

Weight-Bearing

Sling day and night x 4 wks; discontinue sling Phase II (wk 4-8)

Key Restrictions

ER limited to 30 deg (no forceful motion) Phase I; IR limited to belt line Phase I; ABD limited to 90 deg Phase I; no active ROM of involved arm Phase I; no lifting/WB Phase I; no shoulder ER with arm at 90 deg ABD Phase II; avoid forceful ER stretching; no lifting/resisted exercises Phase II; no lifting >5 lbs Phase III; key note: subscapularis repair comes under tension during ER and forward elevation past 90 deg — these motions restricted more than for superior RC tear

Timeline & Phases

5 phases: Phase I (0-4 wks, PROM/protection), Phase II (4-8 wks, AAROM/AROM, D/C sling), Phase III (8-12 wks, initial strengthening, no lifting >5 lbs), Phase IV (12-16 wks, progressive strengthening), Phase V (16+ wks, return to function/sport)

Notes

Standalone subscapularis protocol (distinct from supraspinatus repair); criterion-based; scapular clock in sidelying starts at wk 2; ER with arm at 45 deg ABD introduced Phase II; no ER at 90 deg ABD until Phase III+; IR strengthening introduced cautiously late; tissue quality, repair size, secondary procedures, pre-op ROM all affect progression; references Altintas et al 2019 IJSPT as primary rehab reference. [Archived copy — original Massachusetts General Hospital URL retired in the Mass General Brigham site migration; Wayback snapshot 2025-02-16.]

Surgeon / Author

MGH Sports Medicine