Rotator Cuff Repair Post-Operative Rehabilitation

Dr Terry Hammond

A 56-year-old man has had a rotator cuff repair. What should be the post-operative rehabilitation?
It is extremely important to protect the rotator cuff repair. For the first six weeks there should be no active movement of the shoulder at all. This means the only shoulder exercise should be a "dead arm hang" (see photo). This involves coming out of the sling and hanging the arm vertically down without any active circular pendulum movements. During this period he should come out of the sling to do hand, wrist and elbow exercises. These can be done actively.
After six weeks he can come out of the sling and use the arm for gentle day-to-day activities. No resisted movement or activities should be done. He can gradually increase his activities, going back to manual labour between four and six months after surgery depending on how physical his job is.
We know from animal studies that it takes six months for the repair to become solid. Therefore I advise no strengthening of the rotator cuff repair until at least six months after surgery. We don't worry too much about stiffness after rotator cuff repairs- we know this always resolves although it can take many months.
Physiotherapy protocols are available on my website