Rotator Cuff Surgery Recovery Guide

There are numerous variations in “rotator cuff surgery” that make it challenging to have a single rotator cuff repair protocol. Physical therapists should not follow this as a “cookbook” but rather understand principles for tissue healing, range or motion end feel and scapular mechanics.

Concomitant or Alternative Procedures

• Biceps Tenodesis without Rotator Cuff Repair (RCR) – Sling while walking for 4 weeks and biceps strengthening is not started until 8 weeks
• RCR + Biceps Tenodesis – Same as cuff protocol except sling while walking for 4 weeks and biceps strengthening is not started until 8 weeks\
• Total Shoulder- Same as medium RCR unless Dr. Goradia provides specific subscapularis restrictions
• Reverse Shoulder Replacement – Stop wearing sling the day after surgery. Immediate Active Assisted Range of Motion (AAROM) and Passive Range of Motion (PROM). No restrictions on flexion, abduction or rotation. Early focus on deltoid and scapular kinematics.
• Superior Capsular Reconstruction – Same as massive rotator cuff tears
• Acromioclavicular (AC) Joint reconstruction – Same as massive rotator cuff tears
• Superior Labrum Anterior to Posterior (SLAP) and Bankart repairs – Same as rotator cuff repair protocol except sling for 3 weeks except showering and PT. Progress to full flexion over first 6 weeks. External rotation with arm at side to 20 degrees by 3-4 weeks and progress to full at 6-8 weeks unless firm end feel, then text Dr. Goradia.