Advanced Shoulder Tendon Repair Rehabilitation
A 23-week advanced program for post-shoulder tendon repair, utilizing a pull-up bar, rower, and ankle brace to support recovery of the rotator cuff, labrum, AC joint, and biceps tendon.
Professional rehabilitation program designed for effective recovery and pain management.
Key facts at a glance
- Body part
- upper-limb · shoulder
- Injury type
- tendon-repair
- Level
- advanced
- Duration
- 23
- Sessions/week
- 5
- Minutes/session
- 20
- Evidence level
- high
- ICD-10
- S42
- Cost tier
- moderate
Recovery phases
Passive glenohumeral forward flexion to 90 degrees achieved without pain,External rotation at 90 degrees abduction limited to 0-20 degrees with minimal discomfort,Scapular stabilization in neutral position with minimal compensatory patterns,Pain free passive range of motion in scapular plane,Sternal notch height symmetry maintained during arm positioning,AC joint compression test negative for acute instability
→ Advance to: Phase 2: Intermediate Range of Motion
Active-assisted glenohumeral forward flexion to 140 degrees achieved,External rotation at 90 degrees abduction to 45 degrees without pain,Internal rotation behind back to T8 level,Full passive glenohumeral rotation maintained,Scapular upward rotation during arm elevation within 10 degrees of contralateral side,Biceps tendon resisted testing without reproduction of anterior shoulder pain
→ Advance to: Phase 3: Strengthening
Full active range of motion in all planes matching contralateral shoulder,Rotator cuff strength grade 4+ per manual muscle testing for supraspinatus and infraspinatus,Scapular control during resisted shoulder exercises without winging,Biceps strength grade 4+ with resisted elbow flexion in neutral position,Glenohumeral translation within normal limits on posterior-anterior glide assessment,AC joint stability confirmed with cross-body adduction test negative
→ Advance to: Phase 4: Advanced Strengthening
Rotator cuff strength grade 5 per MMT for all cuff muscles,External rotation strength at 90 degrees abduction equal to contralateral side,Plyometric throwing progression without shoulder pain,Scapular acceleration and deceleration control during overhead activities,Functional reaching above shoulder level without compensation,Labral integrity confirmed with positive compression test negative for symptoms
→ Advance to: Phase 5: Return to Function
Full sport-specific or occupation-specific range of motion achieved,Isokinetic rotator cuff strength within 90% of contralateral side,Throwing velocity or overhead activity performance at pre-injury level,No scapular dyskinesis during high-intensity functional movements,Negative impingement signs in flexion and abduction positions,Patient-reported outcome scores at pre-injury baseline or higher
→ Advance to: Discharge to maintenance
Return to activity milestones
Pain-free basic activities of daily living
Week 6Pain ≤ 3/10 during functional reaching and lifting activities
Light functional activities and conditioning
Week 10No increase in pain at 48-hour follow-up after exercise progression
Moderate activity and sport-specific conditioning
Week 13Elbow flexion and extension range adequate for ADL completion
Full return to sport, occupation, and recreation
Week 23Grip strength ≥ 50% of unaffected side on dynamometry
Precautions
- avoid-overloading
- cool-down-after
- stop-if-pain-increases
Contraindications
- unstable-fixation
- compartment-syndrome
- dvt-risk
- acute-inflammation
Pain management
- Cryotherapy with ice pack to anterior and posterior shoulder for 15-20 minutes
- Non-steroidal anti-inflammatory medication as prescribed
- Soft tissue mobilization to peri-scapular musculature avoiding repair site
- Gentle joint mobilizations to glenohumeral joint within pain-free ranges
- Activity modification and ergonomic education for ADLs
Equipment & modalities
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed October 6, 2026. · Read our editorial policy