1st 6 WEEKS POST-OP (8 weeks for large tear)		Tracey Baker, PT  & Kim Broderick, PT, OCS, ATC, CFMT, MS
		Methodist Sport Rehab	832-556-7750
Size of RCT	Small	Medium	Large
PROM
Flexion	Progress as tolerated by pt to 145 degrees	Progress as tolerated by pt to 120 degrees	Progress as tolerated by pt to 90 degrees
ER (scaption)	Progress as tolerated by pt to 75 degrees	Progress as tolerated by pt to 60 degrees	Progress as tolerated by pt to 45 degrees
ABER	Progress as tolerated to 80 degrees	Hold until 6 weeks post-op	Hold until 8 weeks post-op
IR (scaption)	Progress as tolerated	Progress as tolerated	Progress as tolerated
AAROM	Initiate at 3-4 weeks post-op, not to exceed PROM limits	Wand ER ONLY in scaption plane, gravity assisted progressing to gravity neutral	No AAROM until after 6 weeks post-op (no pulley or wand)
Strengthening
Isometric ER/IR	Initiate at 4 weeks post-op	Initiate at 6 weeks post-op	Hold until 8 weeks post-op
Scapular retraction	Initiate in sling at 2 weeks post-op	Initiate in sling at 2-3 weeks post-op	Initiate in sling at 2-3 weeks post-op
Shrugs	Initiate 4 weeks post-op unresisted	Initiate at 4-6 weeks post-op unresisted	Initiate at 6 weeks post-op unresisted
Seated/Standing Row	Initiate at 4 weeks post-op unresisted	Hold until 6 weeks post-op	Hold until 8 weeks post-op
Prone Row (saw)	Initiate 2-3 weeks post-op, arm to be raised no higher than parallel to chest, weight of arm only	Initiate at 4 weeks post-op, arm to be raised no higher than parallel to chest, weight of arm only	Initiate at 6 weeks post-op, arm to be raised no higher than parallel to chest, weight of arm only
Other Exercises
Pendulums	Initiate during 1st week post-op	Initiate during 1st week post-op	Hold if pt has CPM, show pt pendulum position for dressing/grooming during 1st week post-op
Putty Squeeze	Initiate during 1st week post-op	Initiate during 1st week post-op	Initiate during 1st week post-op
Wrist/Hand AROM	Initiate during 1st week post-op w/ arm supported on table	Initiate during 1st week post-op w/ arm supported on table or in sling	Initiate during 1st week post-op w/ arm in sling
Elbow Flex/Ext	Initiate during 1st week post-op w/ arm at side and shoulder in IR	Initiate during 1st week post-op w/ arm in pendulum position	Initiate during 1st week post-op w/ arm in pendulum position, ensure pt maintains a passive shoulder
6-12 WEEKS POST-OP (14 weeks for large tear)
Size of RCT	Small	Medium	Large
PROM
Flexion	Full ROM by 10-12 weeks post-op	Full ROM by 10-12 weeks post-op	Full ROM by 12-14 weeks post-op
ER (scaption)	Full ROM by 10-12 weeks post-op	Full ROM by 10-12 weeks post-op	Full ROM by 12-14 weeks post-op
ABER	Full ROM by 10-12 weeks post-op	Initiate after 6 weeks post-op and progress as tolerated, full ROM by 10-12 weeks post-op	Initiate after 8 weeks post-op and progress as tolerated, full ROM by 12-14 weeks post-op
IR (scaption)	Full ROM by 10-12 weeks post-op	Full ROM by 10-12 weeks post-op	Full ROM by 10-12 weeks post-op
AROM	Initiate at 4-6 weeks post-op or when pt is released from sling, full ROM all planes by 10-12 weeks	Hold until 6 weeks post-op, full ROM all planes by 10-12 weeks	Hold until 8 weeks post-op, full ROM all planes by 12-14 weeks
Strengthening
Isotonic ER/IR	Neutral or scaption @ 6 weeks post-op progressing to 90/90 position @ 8 weeks post-op	Neutral or scaption @ 6 weeks post-op progressing to 90/90 position @ 8-10 weeks post-op	Neutral or scaption @ 10 weeks post-op progressing to 90/90 position @ 12 weeks post-op
Shrugs	Add resistance at 6 weeks post-op	Add resistance after 6 weeks post-op	Add resistance after 8 weeks post-op
Rows	Add resistance at 6 weeks post-op	Initiate at 6 weeks post-op	Initiate at 8 weeks post-op
Prone T and Y	Initiate at 6 weeks post-op progressing from unilateral prone on table to bilateral prone on table to bilateral prone over ball	Initiate at 6-8 weeks post-op progressing from unilateral prone on table to bilateral prone on table to bilateral prone over ball	Initiate at 10-12 weeks post-op progressing from unilateral prone on table to bilateral prone on table to bilateral prone over ball
Prone extension w/ ER	Initiate at 6 weeks post-op	Initiate at 6 weeks post-op	Initiate at 8 weeks post-op
Bent row or prone row	Add resistance at 6 weeks post-op	Add resistance after 6 weeks post-op	Add resistance after 8 weeks post-op
Upright row	Initiate at 6 weeks post-op	Initiate at 6 weeks post-op	Initiate at 10-12 weeks post-op
Horizontal abduction	Initiate at 6 weeks post-op	Initiate at 6 weeks post-op	Initiate at 10-12 weeks post-op
Deltiod raises	Initiate at 6 weeks post-op	Initiate at 6 weeks post-op	Initiate at 10 weeks post-op
Empty Can	Initiate at 6 weeks post-op	Initiate at 6 weeks post-op	Initiate at 10-12 weeks post-op
Bicep curls/tricep ext	Initiate at 6 weeks post-op	Initiate at 6 weeks post-op	Initiate at 10 weeks post-op
Push up progression	Initiate at 6 weeks post-op, progress wall --> table --> knees -->floor	Initiate at 8 weeks post-op, progress  wall --> table --> knees -->floor	Initiate at 10 weeks post-op, progress   wall --> table --> knees -->floor
Neuromuscular Re-ed
Rhythmic stabilization	Initiate at 6 weeks post-op	Initiate at 6 weeks post-op	Initiate at 8 weeks post-op
Diagonals	Initiate at 6 weeks post-op, progress from supine to standing and unresisted to resisted	Initiate at 6 weeks post-op, progress from supine to standing and unresisted to resisted	Initiate at 8-10 weeks post-op, progress from supine to standing and unresisted to resisted