Advanced Shoulder Tendon Repair Rehabilitation

Program Overview This is a 23-week, advanced rehabilitation guide for people recovering from shoulder tendon repair surgery. It combines supervised manual therapy, progressive exercise, proprioceptive training, cryotherapy, and electrical stimulation into two short sessions per week. The plan is structured in phases, each with clear checkpoints, so you and your care team can move forward only when your shoulder shows it is ready.

Who This Program Is For and Its Goal This program is for people who have had a shoulder tendon repair and are working under clinician guidance toward full function. The goal is to protect the repair early, then gradually restore movement, strength, coordination, and confidence. It is advanced in pacing, not in shortcuts—progress happens only when your symptoms and measurements support it. Your therapist will confirm this plan fits your specific repair.

Before You Start Do not begin without clearance from your surgeon and physical therapist. You will need a hand exerciser and an ankle brace as listed, though these may support general conditioning or positioning rather than the shoulder itself. Make sure you understand the immobilization instructions, your allowed motion limits, and which activities are off-limits. Bring your sling and any prescribed devices to sessions.

Safety Notes and When to Stop Skip or pause exercise if you have active inflammation, severe pain, or any signs of compartment syndrome, such as intense swelling, tightness, numbness, or worsening pain out of proportion. Stop immediately and call your clinician if pain rises during activity, if you feel new weakness, or if symptoms do not settle with rest. Warm up before and cool down after every session as directed.

Weekly Structure You will complete two sessions per week, each about 20 minutes, for 23 weeks. Early weeks focus on protection, sling positioning, and gentle wrist and elbow movement. Middle weeks add passive and assisted motion. Later weeks build resistance, proprioception, and rotator cuff strength. Your therapist adjusts the pace based on your checkpoints, not the calendar alone.

How the Plan Is Organized The 23 weeks are grouped into phases with checkpoints. Phase 1 emphasizes maximum protection, keeping the shoulder immobilized in the prescribed position and avoiding active shoulder motion. Phase 2 introduces passive and active-assisted motion within set limits. Later phases progress resistance, proprioceptive training, and neuromuscular electrical stimulation for the rotator cuff. Expect two short sessions weekly, using the hand exerciser and ankle brace as your therapist directs.

What a Typical Session Looks Like Each session follows a warm-up, main work, and cool-down pattern. Warm-up may include gentle posture and scapular setting. The main work fits your current phase—positioning and protected motion early, then passive, assisted, and resisted exercise with the hand exerciser, plus proprioceptive drills and electrical stimulation as prescribed. Cool-down includes gentle stretching and cryotherapy to settle symptoms before you finish.

Warm-Up, Main Work, Cool-Down Start with a short warm-up focusing on posture and gentle scapular awareness, keeping the shoulder in its allowed position. The main work follows your phase: protected positioning and wrist/elbow motion early; passive and assisted range later; then progressive resistance using the hand exerciser and proprioceptive training. The ankle brace supports general conditioning or positioning as your therapist advises. Finish with a cool-down—gentle stretching and cryotherapy—to reduce soreness.

Tracking Progress Your therapist will track shoulder function and pain using the Constant-Murley Shoulder Score, ASES Score, a pain scale, SANE, goniometric range of motion, and handheld dynamometry for rotator cuff strength. These measures, combined with how your shoulder feels day to day, guide decisions. Keep notes on pain during and after sessions so your team can spot trends and adjust safely.

How Progression Criteria Are Used You move to the next phase only when your checkpoints are met—for example, pain controlled at rest, motion within allowed limits, and no substitution patterns. Early phases require staying immobilized and avoiding active shoulder motion. Later checkpoints include passive range targets and low-resistance isometrics. Outcome measures support these decisions; they never replace your therapist's judgment or your symptom report.

Recovery and Self-Care Between sessions, follow your sling and positioning instructions, keep the elbow protected as advised, and maintain wrist and elbow movement within limits. Use cryotherapy as directed to manage soreness. Prioritize sleep, hydration, and general activity that does not stress the repair. Report any change in swelling, sensation, or pain to your clinician rather than pushing through.

Pain Management Cautions and Red Flags Do not use this guide to self-adjust medication; follow your prescriber's advice. Stop if pain increases during exercise or does not settle with rest, or if you notice severe swelling, tightness, numbness, or worsening weakness. These can be red flags. Contact your clinician promptly. Rest, cooling, and gentle positioning may help mild soreness, but new or escalating symptoms need professional review.