Physiotherapy after Rotator Cuff Repair

Post-operative rehabilitation program and self-physiotherapy

Post-operative physiotherapy

Physiotherapy is a fundamental element of functional recovery after rotator cuff repair. This physiotherapy must progressively adapt to tendon healing at the bone contact according to three defined phases.

The duration of physiotherapy is long since a minimum of 5 to 6 months must be counted for functional recovery.

The three phases of rehabilitation

Phase 1: PASSIVE mobilization

D0 to D45

  • Immobilization with abduction pillow 24/7
  • Strict passive mobilization only
  • Recovery of joint flexibility
  • Muscle relaxation
  • Immediate stop in case of pain

Phase 2: ACTIVE mobilization

D45 to M3

  • Stop abduction pillow
  • Active mobilization without resistance
  • Work against gravity
  • Peri-scapular muscle relaxation
  • No work in force

Phase 3: Strengthening

M3 to M6

  • Progressive work against resistance
  • Shoulder centering
  • Fight against elevation
  • Work in front of mirror
  • Scapular stabilization

Self-Physiotherapy

Self-physiotherapy corresponds to all exercises that will be performed at home by the patient himself. It is fundamental for the functional success of rotator cuff repair, indeed work at the physiotherapy office is not sufficient to consider good recovery.

It is therefore necessary to perform exercises daily at home with a minimum of 5 minutes, 5 times per day. These home exercises will be shown, explained and checked by physiotherapists to ensure they are performed optimally.

Exercises by phase

Phase 1: Passive work

D0 to D45

  • The pendulum: Leaning forward, leave the operated arm in vertical position then perform slight circular movements to relax the muscles around the shoulder.
  • Cervical mobilization: Turn the head slowly from left to right and from top to bottom to relax the para-cervical muscles and trapezius.
  • Shoulder mobilization: Raise the shoulders upward, downward, forward and backward with both shoulders at the same time.

Phase 2: Active work without resistance

D45 to M3

  • Self-elevation of the arm: In lying position, grasp the hand on the operated side with the other hand and perform progressive elevation movements.
  • Work with elastic: Use of low resistance elastic for elevation and rotation movements.
  • Flexibility and relaxation take precedence over strength and locking.

Phase 3: Progressive strengthening

M3 to M6

  • Work in front of a mirror: For shoulder centering and correction of reflex decentering.
  • Work with elastics: For external rotator strengthening and shoulder stabilization.
  • Pulling exercises: Between the shoulder blades to strengthen stabilizing muscles.
  • Fight against elevation: Work to avoid reflex shoulder elevation movements.

Fundamental principles

Work without pain

This is a crucial element. In case of pain during an exercise, it is necessary to stop the exercise performed and try another exercise less likely to cause pain.

Very regular work

Minimum 5 minutes 5 times per day every day. It is important to perform short-duration exercises but several times a day.

Work guided by the physiotherapist

Do not hesitate to ask the physiotherapist for exercises to perform at home and confirm with him the correct performance of movements.