Rotator Cuff Repair — Small Tear with Retraction (≤2 cm)

University of Delaware Physical Therapy · UDPT Clinical Team

Weight-Bearing

Sling with abduction pillow 24 hrs/day weeks 1-2; sling only (no ABD pillow) weeks 3-5; sling in crowds week 4; D/C sling weeks 6-8

Key Restrictions

No IR behind the back (towel stretch); no resisted ABD for 8 weeks; no heavy resisted flexion for 6 weeks; passive IR/ER per surgeon; no passive IR in 0° ABD weeks 3-5; more conservative than uncomplicated due to retraction

Timeline & Phases

Weeks 1-2 (no formal PT, sling+ABD pillow, Codman exercises); Weeks 3-5 (2-3x/week, 6-9 visits: PROM except IR at 0° ABD, scapular stab, AROM except ABD); Weeks 6-8 (1-3x/week, 9-18 visits: ABD progression, D/C sling, PREs except ABD); Weeks 9-11 (1-3x/week, 12-27 visits: PREs all motions, dynamic stab); Weeks 12-16 (1x/week, 17-32 visits: full ROM, MMT 5/5); Weeks 17-24 (sport/work specific); 17-32 visits total

Notes

University of Delaware PT Clinic; small tear with retraction: supraspinatus repair + subacromial decompression; secondary: distal clavicle excision; abduction pillow used first 2 weeks to protect repaired tissue; PT delayed until week 3 (vs week 2 for uncomplicated); full PROM except IR in 0° ABD target by weeks 6-8; return to sport/work weeks 17-24

Surgeon / Author

UDPT Clinical Team