Rotator Cuff — Subscapularis Repair

Saint Louis University (SLUCare)

Weight-Bearing

N/A

Key Restrictions

Sling at all times except exercises wks 1-6; DC sling after wk 6; passive FF limit 100 deg + ER strictly to neutral (0 deg) wks 1-4; ER limit 20 deg wks 4-6; go slow with ER throughout wks 7-12; plyometrics not until wks 16-18; sport-specific/throwing not until wks 20-24

Timeline & Phases

Wks 1-4: sling at all times, HEP distal ROM + scapular retraction, manual scapular manipulation, passive FF to 100 deg, passive ER to 0 deg (neutral only — stricter than standard RC repair); Wks 4-6: sling at all times (DC after wk 6), PROM FF no limits/ER 20 deg/IR 30 deg, Codmans/wand exercises, RTC isometrics arm at 0 deg abduction neutral rotation, scapular stabilization no resistance, abdominal/trunk; Wks 7-12: PROM/AAROM FF/ER/IR full (go slow with ER), wand exercises, posterior capsule stretching, RTC isotonic strengthening, AROM side-lying ER and supine FF, progress to standing FF, ER/IR elastic bands modified neutral, rhythmic stabilization, CKC; Wks 12+: progress isotonic strengthening (lat pulldowns, rows, chest press), posterior capsule stretch, scapular stabilization, isokinetic IR/ER, plyometrics wks 16-18, sport-specific/throwing program wks 20-24

Notes

SLU Sports Medicine and Shoulder Service; diagnosis: subscapularis tear; stricter ER limits than standard rotator cuff repair (ER to 0 deg wks 1-4, ER to 20 deg wks 4-6); go slow with ER wks 7-12; 4-month protocol 2-3 visits/week