Rehabilitation guidelines after rotator cuff repair

Rotator cuff tears that do not respond to non-operative care may require surgical intervention. There are numerous surgical techniques to repair rotator cuff tears. Recently, arthroscopic rotator cuff repairs have become more popular. An abduction pillow is used after rotator repair to alleviate stress on the cuff repair; the use of the pillow ranges 4 to 5 weeks. In the first phase (0 to 4 weeks), the immediate postoperative period, the rehabilitation goals are to (1) protect the healing soft tissues, (2) prevent the negative effects of immobilization, (3) diminish postoperative pain and inflammation. Passive range of motion should be performed to minimize the patient’s chances of developing adhesive capsulite shoulder. Phase II (4 to 6 weeks), the intermediate phase, emphasizes the advancement of shoulder mobility. During this phase, the patients range of motion is gradually increased by using passive, active assisted and active range of motion joint mobilization techniques and stretching (mainly in patients with less motion than desirable). The third phase (up to 6 weeks), the dynamic strengthening phase is focused on improving the patient’s strength, power and endurance while maintaining a functional range of motion of the shoulder joint. Muscular balance and dynamic joint stability should be achieved before aggressive strengthening exercises such as plyometrics or functional throwing