Rotator Cuff Repair — Large Tear, No Retraction (>2.5 cm)

University of Delaware Physical Therapy · UDPT Clinical Team

Weight-Bearing

Sling with ABD pillow 24 hrs/day weeks 1-2; sling (D/C ABD pillow) weeks 3-5; D/C sling weeks 6-10

Key Restrictions

No IR behind the back; no heavy resisted flexion for 6 weeks; no resisted ABD for 8 weeks; no resisted ER for 8 weeks; passive IR/ER per surgeon; no passive IR in 0° ABD; towel stretch may begin week 7; resisted ABD and ER may begin week 9

Timeline & Phases

Weeks 1-2 (no formal PT, sling+ABD pillow); Weeks 3-5 (2-3x/week, 6-9 visits: PROM/AAROM to restrictions, scapular control, rhythmic stab); Weeks 6-10 (1-3x/week, 11-24 visits: full AROM progression, PREs flexion/ext/IR, NMES infraspinatus 8-12 wks PRN); Weeks 11-12 (1-3x/week, 13-30 visits: PREs all motions, dynamic stab, NMES supraspinatus 12-16 wks PRN); Weeks 13-18 (1x/week, 19-36 visits: MMT 5/5, full ROM); Weeks 19-28 (sport/work, interval throwing); 19-36 visits total

Notes

University of Delaware PT Clinic; large tear no retraction: supraspinatus + infraspinatus repair + subacromial decompression; arthroscopic assisted mini-open procedure; secondary: distal clavicle excision; flexion/ABD to 90-120° tolerance weeks 3-5; PRN NMES: infraspinatus 8-12 weeks, supraspinatus 12-16 weeks (EMPI 300PV: 400us/75pps/12s on/50s off; Versastim: 2500Hz/75 bursts); sport-specific and interval throwing progression weeks 19-28; updated May 2009

Surgeon / Author

UDPT Clinical Team

Published

Updated May 2009