Rotator Cuff Repair

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 by MD; no active ROM on land Phase 1; PROM: elevation 140°, ER 40° at 0°/45°/90°, IR thumb to L1; Phase 2 starts 4-8 wks (small/medium tears <3cm) or 6-10 wks (large/massive >3cm); Phase 3 starts 8-12 wks (small/medium) or 10-14 wks (large/massive); full ROM target by 12 wks

Timeline & Phases

Phase 1 (0-4 wks): sling, pendulum exercises, wrist/elbow ROM, grip, scapular exercises, PROM (elevation 140°, ER 40° at 0°/45°/90°, IR thumb to L1), aquatic therapy 2-4 wks (submerged, slow motion, no coronal abduction), no active ROM on land | Phase 2 (4-8 wks small/medium; 6-10 wks large/massive): wean sling, PROM → full ROM, aquatic therapy continuing/progressing, isometric ER/IR, rhythmic stabilization, AAROM → AROM elevation, PNF D1/D2, periscapular strengthening | Phase 3 (8-12 wks small/medium; 10-14 wks large/massive): full ROM target by 12 wks, AROM elevation/scaption in standing, light resistance (theraband/dumbbells), elevation in scapular plane (supine → inclined → upright), serratus punches, sidelying ER, prone rowing/extension, UBE low resistance | Phase 4 (12-16 wks): progress strengthening with weight, gym machines, isokinetics IR/ER 120-240°/sec | Phase 5 (16-24 wks): sport-specific functional progression, interval sport programs, plyometrics with pitchback

Notes

Phase 2 timing depends on tear size: small/medium (<3cm) 4-8 wks, large/massive (>3cm) 6-10 wks; Phase 3 timing: 8-12 wks (small/medium) or 10-14 wks (large/massive) or per physician; pendulum exercises included Phase 1 (compare to RCR+biceps tenodesis protocol 307043 which prohibits pendulums); aquatic therapy begins 2-4 wks; isokinetics IR/ER 120-240°/sec at 12-16 wks; interval sports and plyometrics 16-24 wks; Kremen MD UCLA PatientPop practice site

Surgeon / Author

Thomas Kremen MD