Rotator Cuff Repair — with Biceps Tenodesis

UCLA Department of Orthopaedic Surgery - Sports Medicine · Thomas Kremen MD

Weight-Bearing

N/A (upper extremity)

Key Restrictions

Sling with or without abduction pillow as directed; NO pendulum exercises; no active ROM x 8 wks; PROM Phase 1: elevation to 90° (vs 140° for standard RCR), ER to 40° at 0°/45°/90°; Phase 2 starts 4-8 wks (small/medium <3cm) or 6-10 wks (large/massive >3cm); full ROM target by 12 wks

Timeline & Phases

Phase 1 (0-4 wks): sling, NO pendulum exercises, active wrist/passive elbow ROM, grip, scapular exercises, PROM (elevation 90°, ER 40° at 0°/45°/90°), aquatic therapy 2-4 wks, no active ROM | Phase 2 (4-8 wks small/medium; 6-10 wks large/massive): wean sling, PROM: elevation 140°, ER 40° at 0°/45°/90°, IR thumb to L1, aquatic therapy continuing | Phase 3 (8-12 wks small/medium; 10-14 wks large/massive): full ROM target by 12 wks, isometric ER/IR, rhythmic stabilization, AAROM → AROM elevation, PNF D1/D2, periscapular strengthening, light resistance (theraband/dumbbells), UBE low resistance | Phase 4 (12-16 wks): progress strengthening, gym machines, isokinetics IR/ER 120-240°/sec | Phase 5 (16-24 wks): sport-specific functional progression, interval sports, plyometrics with pitchback

Notes

Combined rotator cuff repair + biceps tenodesis; NO pendulum exercises Phase 1 (unlike standard RCR 307047 which allows pendulums) to protect tenodesis; no active ROM for 8 wks (PROM only Phase 1); PROM elevation Phase 1 starts at 90° (vs 140° for standard RCR) — more conservative initial ROM; Phase 2 and beyond follows same structure as standard RCR with tear-size-dependent timing; isokinetics at 12-16 wks; RTS 16-24 wks; Kremen MD UCLA PatientPop practice site

Surgeon / Author

Thomas Kremen MD