Download Small Rotator Cuff Tears Rehab Protocol

1-4 Weeks:

  • Sling Immobilization
  • Active ROM Elbow, Wrist and Hand
  • True Passive (ONLY) ROM Shoulder. NO ACTIVE MOTION.
    • Pendulums
    • Supine Elevation in Scapular plane = 140 degrees
    • External Rotation to tolerance with arm at side. (emphasize ER,
      minimum goal 40°)
  • Scapular Stabilization exercises (sidelying)
  • Deltoid isometrics in neutral (submaximal) as ROM improves
  • No Pulley/Canes until 5 weeks post-op (these are active motions)

4-8 Weeks:

  • Discontinue abduction pillow at 4 weeks post-op
  • Discontinue sling use at 5 weeks post-op
  • Begin Active Assist ROM and advance to Active as Tolerated
    • Elevation in scapular plane and external rotation as tolerated
    • No Internal rotation or behind back until 6wks
  • Begin Cuff Isometrics at 5 wks with arm at the side

8-12 Weeks:

  • Active Assist to Active ROM Shoulder As Tolerated
    • Elevation in scapular plane and external rotation to tolerance
    • Begin internal rotation as tolerated
    • Light stretching at end ranges
  • Cuff Isometrics with the arm at the side
  • Upper Body Ergometer

3-12 Months:

  • Advance to full ROM as tolerated with passive stretching at end ranges
  • Advance strengthening as tolerated: isometrics — bands — light weights (1-5 lbs); 8-12 reps/2-3 sets per rotator cuff, deltoid, and scapular stabilizers
  • Only do strengthening 3x/week to avoid rotator cuff tendonitis
  • Begin eccentrically resisted motions, pylometrics (ex. Weighted ball toss), proprioception (es. body blade)
  • Begin sports related rehab at 4 ½ months, including advanced conditioning
  • Return to throwing at 6 months
  • Throw from pitcher’s mound at 9 months
  • Collision sports at 9 months
  • MMI is usually at 12 months post-op

Please note that these instructions are general guidelines to be followed; however, any written or verbal instructions provided by Dr. Nwachukwu supersede the instructions below and should be followed.