Phase 1 of your recovery lasts approximately 3 weeks. Your goals are to minimize shoulder pain and inflammation while protecting the integrity of your surgical repair. You work on gradually restoring your passive range of motion and restore your scapular function.
Of course, you need to take precautions to protect your shoulder as you recover. You must not engage in any active range of motion exercises, including extending, rotating, or stretching your arm. Don’t lift anything with your operative arm. You need to wear your sling all the time, only taking it off to shower and during your physical therapy. You also need to keep your incision clean and dry.
During phase 1, you work on some activities to increase your range of motion and start to rebuild your strength. You and your physical therapist work on passive and active range of motion movements in your hand, wrist, and elbow. You will also work on passive range of motion movements including:
You need to sleep while wearing your sling and place a towel under your elbow to prevent hyperextension. You might also find that cryotherapy reduces your inflammation and pain.
You need to reach specific criteria to move on to the next phase of your rehabilitation, including:
Phase two usually lasts from week 4-9. During this time, you focus on minimizing your shoulder pain and swelling while gradually restoring your active range of motion and reducing the time you spend wearing your sling. You should continue to take precautions to protect your shoulder. You should:
You and your physical therapist continue to work on passive range of motion movements including:
As you progress through phase 2, you increase your range of motion and begin to incorporate rhythmic stabilization drills and other active range of motion movements, including abductions and elevation. You continue to build strength in your shoulder, back, and chest with scapular retractor movements and upward rotators. You also work on active range of motion movements in your hand, wrist, and elbow.
By the end of phase two, you will work on adding low weight (1-3 pounds) to your exercises and increasing your repetitions. You should also be able to achieve nearly full elevation in the scapular plane (raising your arm to the side). Additionally, you will work on:
To progress to phase 3 of your rehabilitation, you need to achieve:
Phase 3 typically lasts from weeks 12-15, and you focus on rebuilding your strength, endurance, and neuromuscular control. Your goals are to return to full chest level functional activities and gradually increase the stress your shoulder can sustain.
While building your shoulder strength, you need to take care not to over-stress your shoulder and avoid all contact sports and activities. You should also only progress as directed by your physical therapist.
Phase 3 activities include:
By the end of phase 3, you should be able to perform all movements without pain and to the full range of motion.
Phase 4 lasts from week 16-24, and your goals are to maintain your passive and active range of motion stretches and exercises while you return to strenuous activity and full recreational activities.
Even though you’re at the end of your rehabilitation, you still need to take care to protect your shoulder. For example, you can avoid excessive anterior capsule stress by avoiding movements like tricep dips, wide grip bench presses, and behind-the-head lat pulls. You should also avoid any throwing or overhead athletic movements until your surgeon clears you.
During phase 4, you continue with all the exercises and movements you’ve added during the previous 16 weeks. You will also add:
By the end of your rehabilitation, your surgeon will clear you to return to all activities if you have no pain or instability, have restored your range of motion and the full strength and endurance of your rotator cuff. You should continue your exercises and stretches at home to maintain your range of motion, flexibility, and strength.
