This is a generalized protocol and may need modifications depending on the type and severity of tear. We recommended you perform these exercises under the supervision of your physiotherapist and also stick to your surgeon’s advice.

Phase I
(Weeks 1-6):


  • Maintain integrity of repair
  • Diminish pain and inflammation
  • Prevent muscular inhibition, prevent stiffness
  • Regain range of motion
  • No active range of motion (AROM) of Shoulder
  • Maintain arm in sling, remove only for exercise
  • No lifting of objects
  • No shoulder motion behind back
  • No excessive stretching or sudden movements
  • No supporting of body weight by hands
  • Keep incision clean and dry
  • Abduction brace / sling: wear the sling most of the times. Come out of the sling every 2 hours to perform exercises.
  • Sleep in brace / sling
  • scapular pinches, shrugs; Neck ROM
  • Ball squeezes; active wrist, elbow movements, Cryotherapy for pain and inflammation
  • Pendulum Exercises
  • Start passive ROM to tolerance (at 15 days)
  • Supine passive elevation
  • Supine external rotation
  • Internal rotation (start after week 3)
Phase II (Week 6-12):
  • Allow healing of soft tissue
  • Do not overstress healing tissue
  • Gradually restore full passive ROM
  • Decrease pain and inflammation
    • No lifting
    • No supporting of body weight by hands and arms
    • No excessive behind the back movements
    • No sudden jerking motions
  • Discontinue brace / sling at end of week 6
  • Gentle Scapular/glenohumeral joint mobilization as indicated to regain full passive ROM
  • Continue previous exercises in Phase I
  • Supine external Rotation with Abduction
  • External rotation @ 90o abduction
  • Supine Cross-Chest Stretch
  • wall stretches
  • overhead pullies
Active exercises:
  • Side-lying External Rotation
  • Prone Horizontal Arm Raises “T”
  • Prone row
  • Prone scaption “Y”
  • Prone extension
  • Active assisted elevation, progressing to: Standing Forward Flexion (scaption) with scapulohumeral rhythm
Resisted exercises:
  • Resisted forearm supination-pronation
  • Resisted wrist flexion-extension
  • Sub-maximimal isometric exercises: internal and external rotation at neutral
Phase III – (week 12-18):
  • Maintain full non-painful active ROM
  • Continue strengthening

Continue stretching and dynamic strengthening exercises as before
ADD: hands behind head stretch, sleeper stretches, doorway stretches.

  • Theraband strengthening:
  • External Rotation
  • Internal Rotation
  • Standing Forward Punch
  • Shoulder Shrug
  • Dynamic hug “W”’s
  • Seated Row
  • Biceps curls
Phase IV (week 18-24):
  • Restore full motion
  • Restore full strength
  • Gradual return to normal activities

Stretching exercises as before Dynamic strengthening exercises as before, limit weight to 5 pounds.

  • Standing forward flexion “full-can” exercise
  • Prone external rotation at 90° abduction “U’s
  • Push-up with progression
Theraband exercises:
As before, add:
  • External rotation at 90°
  • Internal rotation at 90°
  • Standing ‘T’s
  • Diagonal up Diagonal down

Sports that involve throwing and the use of the arm in the overhead position are the most demanding on the rotator cuff. We will provide you specific instructions on when and how to return to sports. A rough guideline as to when to return to sport (minimum duration) is as follows:

Golf: 6 months
Weight Training: 6 months
Tennis: 6 -8 months
Swimming: 6-8 months
Throwing: 6 – 8 months

Before returning safely to your activity, you must have full range of motion, full strength and no swelling or pain. Your doctor or physical therapist will provide you with guidelines regarding your training.