Advance Rehabilitation After Rotator Cuff Repair Before Return to Sports

Standing Row

Use an elastic stretch band of comfortable resistance. Make a 3 foot long loop with the elastic band and tie the ends together. Attach the loop to a doorknob or other stable object.

Stand holding the band with your elbow bent and at your side, as shown in the start position. Keep your arm close to your side and slowly pull your elbow straight back. Slowly return to the start position and repeat.

Squeeze your shoulder blades together as you pull. Start with 3 sets of 8 and as the exercise becomes easier to perform, progress to 3 sets of 12 repetitions.

External Rotation With Arm Abducted 90°

Make a 3 foot long loop with the elastic band and tie the ends together. Attach the loop to a doorknob or other stable object. Stand holding the band with your elbow bent 90° and raised to shoulder height, as shown in the start position.

Keeping your shoulder and elbow level, slowly raise your hand until it is in line with your head. Slowly return to the start position and repeat. Make sure your elbow stays in line with your shoulder.

Start with 3 sets of 8 and as the exercise becomes easier to perform, progress to 3 sets of 12 repetitions.

Internal Rotation (Standing)

Make a 3 foot long loop with the elastic band and tie the ends together. Attach the loop to a doorknob or other stable object. Stand holding the band with your elbow bent and at your side, as shown in the start position.

Keep your elbow close to your side and bring your arm across your body. Slowly return to the start position and repeat.

Start with 3 sets of 8 and as the exercise becomes easier to perform, progress to 3 sets of 12 repetitions.

External Rotation (Standing)

Make a 3 foot long loop with the elastic band and tie the ends together. Attach the loop to a doorknob or other stable object. Stand holding the band with your elbow bent and at your side, as shown in the start position.

Keeping your elbow close to your side, slowly rotate your arm outward. Slowly return to the start position and repeat. Squeeze your shoulder blades together when you pull your elbow back.

Start with 3 sets of 8 and as the exercise becomes easier to perform, progress to 3 sets of 12 repetitions.

Elbow Flexion

Stand tall with your weight evenly distributed over both feet. Keep your elbow close to your side and slowly bring the weight up toward your shoulder as shown. Hold for 2 seconds. Slowly return to the starting position and repeat. Do not do the exercise too quickly or swing your arm.

Begin with a weight that allows 3 sets of 8 repetitions and progress to 3 sets of 12 repetitions. As the exercise becomes easier, add weight in 1 pound increments to a maximum of 5 pounds. Each time you increase the weight, start again at 3 sets of 8 repetitions.

Elbow Extension

Stand tall with your weight evenly distributed over both feet. Raise your arm and bend your elbow with the weight behind your head. Support your arm by placing your opposite hand on your upper arm.

Slowly straighten your elbow and bring the weight overhead. Hold for 2 seconds. Slowly lower your arm back down behind your head and repeat. Keep your abdominal muscles tight and do not arch your back.

Begin with a weight that allows 3 sets of 8 repetitions and progress to 3 sets of 12 repetitions. As the exercise becomes easier, add weight in 1 pound increments to a maximum of 5 pounds. Each time you increase the weight, start again at 3 sets of 8 repetitions.

Trapezius Strengthening

Place your knee on a bench or chair and lean forward so that your hand reaches the bench and helps support your weight. Your other hand is at your side, palm facing your body.

Slowly raise your arm, rotating your hand to the thumbs up position and stopping when your hand is shoulder height, with your arm parallel to the floor. Slowly lower your arm to the original position to a count of 5.

Use a weight that makes the last few repetitions difficult but pain free. Begin with a light enough weight to allow 3 to 4 sets of 20 repetitions without pain. As the exercise becomes easier to perform, add 2 to 3 pounds of weight, but do fewer repetitions. Progress to 3 sets of 15 repetitions at each weight increment, with the maximum weight approximately 5 to 7 pounds.

Scapula Setting

Lie on your stomach with your arms by your sides. Place a pillow under your forehead for comfort if required.

Gently draw your shoulder blades together and down your back as far as possible. Ease about halfway off from this position and hold for 10 seconds. Relax and repeat 10 times. Do not tense up in your neck.

Scapular Retraction / Protraction

Lie on your stomach on a table or bed with your injured arm hanging over the side. Keep your elbow straight and lift the weight slowly by squeezing your shoulder blade toward the opposite side as far as possible.

Return slowly to the starting position and repeat. Do not shrug your shoulder toward your ear. Begin with a weight that allows 2 sets of 8 to 10 repetitions and progress to 3 sets of 15 repetitions.

As the exercise becomes easier, add weight in 1 pound increments to a maximum of 5 pounds. Each time you increase the weight, start again at 2 sets of 8 to 10 repetitions.

Bent Over Horizontal Abduction

Lie on your stomach on a table or bed with your injured arm hanging over the side. Keep your arm straight and slowly raise it up to eye level. Slowly lower it back to the starting position and repeat.

Begin with a weight that allows 3 sets of 8 repetitions and progress to 3 sets of 12 repetitions. As the exercise becomes easier, add weight in 1 pound increments to a maximum of 5 pounds. Each time you increase the weight, start again at 3 sets of 8 repetitions.

Internal and External Rotation (Supine)

Lie on your back on a flat surface. Extend your arm straight out from the shoulder and bend the elbow 90° so that your fingers are pointed up. Keeping your elbow bent and on the floor, slowly move your arm in the arc shown.

Bring your elbow down to a 45° angle if you experience pain at 90°. Use a weight that makes the last few repetitions difficult but pain free.

Begin with a light enough weight to allow 3 to 4 sets of 20 repetitions without pain. As the exercise becomes easier to perform, add 2 to 3 pounds of weight, but do fewer repetitions. Progress to 3 sets of 15 repetitions at each weight increment, with the maximum weight approximately 5 to 7 pounds.

External Rotation (Side Lying)

Lie on your side on a firm, flat surface with your unaffected arm under you, cradling your head. Hold your injured arm against your side as shown, with your elbow bent at a 90° angle.

Keep your elbow against your side and slowly rotate your arm at the shoulder, raising the weight to a vertical position. Slowly lower the weight to the starting position to a count of 5.

Begin with weights that allow 2 sets of 8 to 10 repetitions (approximately 1 to 2 pounds) and progress to 3 sets of 15 repetitions. As the exercise becomes easier, add weight in 1 pound increments to a maximum of 5 pounds. Each time you increase the weight, start again at 2 sets of 8 to 10 repetitions.

Internal Rotation (Side Lying)

Lie on a firm, flat surface on the side of your affected arm. Place a pillow or folded cloth under your head to keep your spine straight. Hold your injured arm against your side as shown, with your elbow bent at a 90° angle.

Keep your elbow bent and against your body and slowly rotate your arm at the shoulder, raising the weight to a vertical position. Slowly lower the weight to the starting position.

Do not let your body roll back as you raise the weight. Begin with weights that allow 2 sets of 8 to 10 repetitions (approximately 1 to 2 pounds) and progress to 3 sets of 15 repetitions. As the exercise becomes easier, add weight in 1 pound increments to a maximum of 5 pounds. Each time you increase the weight, start again at 2 sets of 8 to 10 repetitions.

External Rotation Eccentric

Lie on your side with your elbow bent and your hand resting across your stomach.

Rotate your hand toward the ceiling, keeping your elbow tucked against your body. Slowly lower your hand back down to your stomach, controlling the movement against the resistance throughout the descent.

Progressive Strengthening of the Posterior Cuff Muscles

This exercise is accomplished in a standing position while performing external rotation of the shoulder at 45 degrees of abduction utilizing elastic resistance.

Begin with weights that allow 2 sets of 8 to 10 repetitions (approximately 1 to 2 pounds) and progress to 3 sets of 15 repetitions as tolerated.

Push Up Progression

Repetitions: Progress from 2 sets of 10 to 3 sets of 10 repetitions.

Push Up at Wall

Stand facing a wall. Place your hands on the wall at shoulder height with your elbows straight. Lean forward, allowing your elbows to bend and move outward until your nose is near the wall. Push yourself back from the wall using your arms.

Push Up Incline (Table)

Assume a plank position with your hands on a secure table or elevated surface. Lower your chest toward the support surface and then press back to the start position.

Push Up on Knees

Lie on your stomach and keep your hands beside your shoulders. Engage your core and squeeze your buttocks. Imagine your body is a solid plank. Push up onto your knees without sagging.

Pause at the top of each push up and gently push your shoulders slightly forward. On the way back down, touch your nose to the floor. Keep your hips and back straight and your chin tucked.

Push Up on Toes

Lie on your stomach. Keep your hands beside your shoulders and press your body away from the floor into a full plank position. Lower your body down with control.

Plyometric Program

Throw With Arm at Side

For the right arm, stand sideways so that your left side is facing a rebounder or wall. Keep the right elbow tucked against your right side with the elbow at a right angle.

Throw a 1 to 2 pound ball across the body, keeping the elbow tucked to the side, to the rebounder. Catch the rebounded ball in the same arm position, allowing the arm to comfortably stretch back, and then quickly throw the ball again. Do not pause or stop the ball movement after catching it.

Wall Dribbles Overhead

Stand facing a wall with your arm held comfortably overhead, above the shoulder joint. Quickly dribble a 1 to 2 pound ball against the wall using your fingertips.

Rebounder Throwing

Stand facing a rebounder, with the arm raised in the throwing position. Throw a 1 to 2 pound ball and then catch the rebounded ball in the same throwing position.

On the catch, allow the arm to comfortably rotate backward and then quickly throw the ball again. Do not pause or stop the ball movement after catching it.

Decelerations

Kneel on the floor on the knee on the same side as your throwing arm. Flip a 1 or 2 pound ball backwards over your throwing shoulder to a coach or partner standing behind you.

Have the partner toss the ball so that you can catch it in the throwing position and then decelerate your arm forward through your throwing motion. Quickly flip the ball backward again and repeat.

Wall Dribble 90’s

Stand facing the wall. Raise the arm into your throwing position. Keeping the elbow close to the wall, quickly bounce a 1 to 2 pound ball against the wall in this position.

As you catch the ball, allow the arm to comfortably stretch back into external rotation. Quickly bounce the ball on the wall again. Do not pause or stop the ball movement after catching it.

Wall Dribble Semi Circles

Stand facing the wall. Raise the arm into an overhead position. Keeping the elbow close to the wall, quickly bounce a 1 to 2 pound ball against the wall using your fingertips.

Dribble the ball as you move your arm in an arc from above your head down to shoulder level and back.

Proprioception Exercises

Shoulder D1 Pattern

Stand with good posture. Have your arm down at your side, rotated in, with the thumb pointed down.

Bring your arm and hand upward and across your body. As you do so, rotate your hand outward. Finish with your thumb pointed upward and your hand slightly above your head.

Shoulder D2 Pattern

Stand with good posture. Start with your arm across your body with your hand rotated in, thumb pointed down.

Bring your arm up and across your body diagonally. As you do, rotate your hand outward. Finish with your hand above your head and out to the side.

Shoulder Y Position Exercises

Stand near a wall with a foam roller under your forearms as shown. Slide your hands up the wall into a Y position.

Shoulder Circles

Stand with good posture, hand on a ball at shoulder height. Make small circles with the ball, both clockwise and counterclockwise.