Rotator Cuff Repair: Week-by-Week Guide

At a Glance

• The repair must heal before it can be loaded — protection comes first
• Follow the sling schedule exactly; do not remove it early
• Movement order: passive range → gentle activation → strength → sport
• Return to throwing or heavy lifting is earned by criteria, not a calendar date

The First Weeks

Week 0–6 (protection):

• Wear the sling as directed — often day and night for 4–6 weeks
• Do gentle pendulum exercises only if cleared
• Move the hand, wrist and elbow freely
• Do not lift, pull, push or reach with the operated arm
• Sleep supported with pillows to avoid rolling onto the shoulder

Week 6–12 (early movement):

• Start active-assisted range with the other arm, a wand or a table
• Begin isometric shoulder holds as cleared
• Work shoulder-blade control with scapular retractions
• Stop using the sling gradually as directed

Months 3–6 (strength)

• Progress to external rotation with a band and internal rotation
• Add progressive scapular and shoulder strengthening
• Use very light loads; no heavy or overhead lifting without clearance

Months 6–12 (return)

• Progress resistance one variable at a time
• Return to overhead work and throwing only when strength and range criteria are met
• Keep strengthening long after symptoms settle
• Use return-to-sport testing, not a date on the calendar

Do This

• Protect the repair in the first 6 weeks — it is weakest then
• Keep the hand, wrist and elbow moving while the shoulder rests
• Do the passive-range work even though it seems "too easy"
• Follow the rotator cuff repair rehabilitation guide phases

Avoid This

• Removing the sling too early
• Actively lifting the arm overhead during the protection phase
• Pulling, pushing or supporting body weight on the arm until cleared
• Returning to lifting or throwing before strength criteria are met

When to See Someone

Contact your surgeon for a red, hot or leaking wound, fever, sudden severe pain, or a shoulder that looks or feels out of place.

References

1. AAOS OrthoInfo. "Rotator Cuff Tears." https://www.orthoinfo.org/en/diseases--conditions/rotator-cuff-tears/
2. JOSPT. "An Update of Systematic Reviews Examining the Effectiveness of Conservative Physical Therapy Interventions for Subacromial Shoulder Pain." 2020. https://www.jospt.org/doi/10.2519/jospt.2020.8498

This information is for education only and is not a medical diagnosis. InjuryAtlas does not replace an assessment by a qualified health professional. Always follow your surgeon's specific post-operative protocol.