Rotator Cuff Injury and Repair

Most of the shoulder injuries and pain are related to rotator cuff muscles. Rotator cuff consists of four small muscles which stabilize and control shoulder movements on the shoulder blade. These muscles are vulnerable to rotator cuff tear, rotator cuff tendonitis and rotator cuff impingement related injuries. The common cause of these injuries are repetitive shoulder movements, overused muscles and poor biomechanics. Physiotherapy is usually the first line of treatment to reduce pain, inflammation and to restore proper movement pattern. Shock wave therapy is very effective in treating rotator cuff related shoulder pain.

Massive rotator cuff tear commonly requires surgery. More attention has to be given after the surgery to lower the risk of re-tearing. Post-surgery, at MoveFree Physio we follow specialized criteria-based protocol to gradually regain shoulder strength and function.

Our rotator cuff repair post-operative rehabilitation protocol consists of four phases with set goals:

Phase I: Immediate Post-Surgical Phase (Weeks 0-4)

  • No active ROM of shoulder
  • No lifting, reaching behind back, excessive stretching or sudden movements
  • Maintain arm in brace, sling; remove only for exercise
  • Sling use for 4 – 5 weeks
  • No support of body weight by hands
  • Keep incision clean and dry

Phase II: Protection and Protected Active Motion Phase (Weeks 5-12)

  • No lifting
  • No supported full body weight with hands or arms
  • No sudden jerking motions
  • No excessive behind back motions
  • No bike or upper extremity ergometer until week 6

Phase III: Early Strengthening (Weeks 10-16)

  • No lifting objects > 5lbs, no sudden lifting or pushing
  • Exercise should not be painful

Phase IV: Advanced Strengthening Phases (Weeks 16-22)

  • Maintain full non-painful AROM
  • Advanced conditioning exercise for enhanced functional and sports-specific use
  • Improve muscular strength, power and endurance
  • Gradual return to all functional activities