Rotator Cuff Repair — Small to Medium Tears (≤3 cm)

Massachusetts General Hospital · MGH Sports Medicine

Weight-Bearing

Sling in neutral rotation with abduction pillow (30-45 deg); use at night through Phase II; discontinue Phase III (wk 7-8)

Key Restrictions

No shoulder AROM/AAROM Phase I; no lifting Phase I-II; no supporting body weight; PROM ER ≤20 deg scapular plane Phase I-II; PROM FF ≤90 deg Phase I-II; no behind back stretching; avoid scapular retraction with teres minor repair; subscapularis repair: no ER past 0 deg if PROM initiated Phase I, initiate scapular retraction/depression/protraction Phase III only; biceps tenodesis: no active elbow flexion x 4 wks; concomitant biceps tenodesis/tenotomy: PROM elbow flexion only Phase I

Timeline & Phases

6 phases: Phase I (0-3 wks, PROM only), Phase II (4-6 wks, AAROM, sling at night), Phase III (7-8 wks, AROM, discontinue sling), Phase IV (9-10 wks, light resistance), Phase V (11-14 wks, progressive strengthening), Phase VI (15+ wks, return to function/sport)

Notes

Criterion-based; covers small (<1 cm) and medium (1-3 cm) tears; use large/massive protocol for tears >3 cm or >1 tendon involvement; subscapularis repair precautions embedded; teres minor repair: avoid scap retraction Phase I-II; complications to monitor: fever, numbness/tingling, excessive drainage; tear size definitions not explicitly stated but references large/massive as >3 cm. [Archived copy — original Massachusetts General Hospital URL retired in the Mass General Brigham site migration; Wayback snapshot 2026-02-28.]

Surgeon / Author

MGH Sports Medicine