Phase I: Protection and Early Mobilisation (0–6 Weeks)

Immobilisation:

• Sling worn for comfort and protection.

• Removed for therapy and hygiene.

Precautions:

• Protect the repair.

• Avoid lifting, pushing, or pulling with the operated arm.

• Avoid resisted shoulder movements.

• Avoid weight bearing through the arm.

• Compared with a full rotator cuff repair, a partial repair typically allows:

• Earlier progression of active shoulder motion

• Earlier introduction of strengthening

• Shorter duration of sling use

Therapy:

• Hand, wrist, and elbow range of motion exercises.

• Passive and active-assisted shoulder range of motion within comfort.

• Pendulum exercises.

• Scapular setting and postural exercises.

• Pain and oedema management.

Criteria to Progress:

• Pain controlled.

• Tolerating passive and active-assisted shoulder motion without increased symptoms.

Phase II: Controlled Motion Phase (6–12 Weeks)

Immobilisation:

• Sling gradually weaned and discontinued.

Precautions:

• Avoid lifting and resisted overhead activity.

• Avoid sudden or uncontrolled shoulder movements.

Therapy:

• Progress active shoulder range of motion in all planes as tolerated.

• Continue scapular stabilisation exercises.

• Begin gentle isometric strengthening of the rotator cuff and deltoid.

Criteria to Progress:

• Functional active shoulder range of motion.

• Minimal pain with daily activities.

Phase III: Strengthening Phase (12–16 Weeks)

Precautions:

• Avoid heavy lifting and high-load overhead activity.

Therapy:

• Progress strengthening of the rotator cuff and periscapular musculature.

• Functional strengthening for activities of daily living.

• Endurance and proprioceptive training.

Criteria to Progress:

• Near full, pain-free shoulder range of motion.

• Improving strength and functional use of the arm.

Phase IV: Advanced Strengthening & Functional Return (4–6 Months)

Precautions:

• Gradual return to higher-demand activities only once strength and control are restored.

Therapy:

• Advanced strengthening and functional training.

• Work- and sport-specific rehabilitation as required.

Criteria to Discharge:

• Stable, pain-free shoulder function.

• Strength appropriate for work and recreational activities.

• Clearance by the treating surgeon.

General Recommendations

Work:

• Office/desk work may resume after 2–4 weeks if pain is well controlled

• Manual labour should be deferred until 3–6 months depending on job demands

Driving:

• It is important that you are medically fit to return to driving and you feel safe to control the vehicle and take evasive action if needed.

Sports and Leisure:

• Gentle lower-limb and non–shoulder loading activities (e.g. walking, stationary cycling) may resume as comfort allows.

• Light recreational activities involving the shoulder may resume after 3–4 months.

• Overhead sports, heavy lifting, and high-demand or contact activities should only resume after full clearance by the treating surgeon, typically after 5–6 months.

Disclaimer: This protocol is intended as a general rehabilitation guide only. Rehabilitation progression should always be individualised and may be modified by A/Prof Ernstbrunner and the treating rehabilitation team based on the patient’s clinical progress, surgical findings, and individual circumstances.