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Physical Therapy and Rehabilitation after Rotator Cuff Repair: A Review of Current Concepts

Austin Vo, Hanbing Zhou, Guillaume Dumont, Simon Fogerty, Claudio Rosso and Xinning Li

Rotator cuff pathology can contribute to shoulder pain, weakness, and limitations to both activities and work. Surgical repair via open or arthroscopic techniques is associated with improved function and patient satisfaction. Success of repair depends on several factors that include patient age, tear size, type of fixation, smoking status, and compliance with the postoperative therapy. Both meticulous surgical technique and postoperative rehabilitation are essential to patient outcomes. Controversy exists as to the timing of motion after rotator cuff repair. Recent evidence suggests that early range of motion is not detrimental to the healing process and reported similar functional results when compared to immobilization. Postoperative therapy should be individualized based on the size of tear, type of repair, and specific patient factors. Essential components include four basic phases ranging from passive range of motion to the final stage of advanced strengthening. Both aquatherapy and self directed home exercises have been shown to be advantageous in the postoperative phase. Physicians must educate the patient and also collaborate with the physical therapist during all phases of the postoperative rehabilitation phase to improve outcome and patient satisfaction.