REHAB PROTOCOL · SHOULDER

Rotator Cuff Repair Rehab Protocol

By Dr. Shayne Kelly, DO — Fellowship-Trained Sports Medicine Surgeon · Tri-City Orthopedics, Kennewick, WA

The written protocol Dr. Kelly provides to his patients and their physical therapists in the Tri-Cities. Time frames are guidelines — progression is criteria-based, and your own post-op instructions always govern.

⬇ Printable protocol (PDF)Request an appointment →

Educational information, not medical advice. This is not a substitute for the specific instructions Dr. Kelly and your physical therapist give you. Your timeline depends on your surgery, your body, and your progress. Follow your own care team's directions. In an emergency, call 911.

1–4 Weeks

PROTECT THE REPAIR

4–6 Weeks

PROGRESS MOTION

6–12 Weeks

ACTIVE MOTION

3–12 Months

STRENGTHEN & RETURN

1–4 WeeksPROTECT THE REPAIR

•Sling Immobilization; active ROM elbow, wrist and hand; true passive (ONLY) ROM shoulder. NO ACTIVE MOTION.
•Pendulums; supine elevation in scapular plane = 140°
•External Rotation to tolerance with arm at side. (Emphasize ER, minimum goal 40°)
•Scapular Stabilization exercises (side lying); deltoid isometrics in neutral (submaximal) as ROM improves
•No Pulley/Canes until 6 weeks post-op (these are active motions)
•If biceps tenodesis was performed, no resisted elbow flexion until 8 weeks

GOALS Protect the repair

4–6 WeeksPROGRESS MOTION

•Discontinue sling use; 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 6wks with arm at the side
•If biceps tenodesis was performed, no resisted elbow flexion until 8 weeks

GOALS PROM toward full

6–12 WeeksACTIVE MOTION

•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; if biceps tenodesis was performed, no resisted elbow flexion until 8 weeks

GOALS Full AROM, normal rhythm

3–12 MonthsSTRENGTHEN & RETURN

•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, plyometrics (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

GOALS Overhead when cleared

Return to Sport & Discharge Criteria

•Full pain-free AROM with normal scapulohumeral rhythm
•Cuff and periscapular strength ≥90% of opposite side
•Overhead sport / heavy labor only when cleared by Dr. Kelly

Time frames are guidelines — progress when phase goals are met, per Dr. Kelly and the treating therapist.

Procedure variants — printable protocols

When to call

Increasing pain, numbness, redness, drainage from the wound, or fever/chills — call (509) 460-5588. After hours, the answering service can reach Dr. Kelly. If your issue feels emergent, call 911 or go to the nearest emergency department.

Physical therapists

Treating one of Dr. Kelly's patients? Download the printable protocol for your clinic, and call (509) 460-5588 with questions about an individual patient's progression.

⬇ Protocol PDF

Related protocols

SHOULDERShoulder Stabilization (Bankart)SHOULDERReverse Total Shoulder Replacement ELBOWDistal Biceps Tendon Repair

Back on the field starts with a plan.

Fellowship-trained sports medicine care in Kennewick, Richland & Pasco.

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