Intermediate Shoulder Tendon Repair Rehab
A 6-week intermediate program focused on shoulder tendon repair, utilizing hand exercisers, pull-up bars, weight vests, therapy putty, and knee braces to target 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
- intermediate
- Duration
- 6
- Sessions/week
- 3
- Minutes/session
- 60
- Evidence level
- moderate
- ICD-10
- S42
- Cost tier
- moderate
Shoulder Tendon Repair Rehabilitation Program — Intermediate Level (6 Weeks)
This program is for people recovering from shoulder tendon repair who have completed initial protection and are ready for a structured intermediate phase. Over six weeks it aims to gradually restore shoulder movement, rebuild rotator cuff and scapular strength, and return you toward everyday function. Your therapist will tailor the pace to your healing, symptoms, and goals, and will adjust the plan if your shoulder responds differently than expected.
Before You Start
Only begin this program under your clinician's supervision, and confirm it suits your repair. This plan is not appropriate if you have severe osteoporosis, active inflammation, an unstable fixation, or compartment syndrome. Always warm up first, and stop if pain increases or you feel sharp pain, new weakness, swelling, or numbness—contact your clinician rather than pushing through. Never add resistance or range beyond what your therapist has cleared.
Weekly Structure
The plan runs six weeks with three sessions per week, about sixty minutes each. Early weeks emphasize gentle, therapist-guided motion and protection; middle weeks add active-assisted and active movement; later weeks build controlled strengthening and scapular stability. Equipment such as therapy putty, a hand exerciser, and light weights supports grip and shoulder work, while a pull-up bar, weight vest, and knee brace are used only as your therapist directs for your specific needs.
What a Typical Session Looks Like
Each session follows a warm-up, main work, and cool-down pattern. Warm-up uses gentle pendulum or assisted motion. The main portion combines manual therapy, stretching, strengthening, and scapular stabilization with therapy putty, hand exerciser, and graded resistance. Cool-down may include ice and, where cleared, modalities like TENS or ultrasound. Sessions finish calm and controlled, with pain staying low throughout.
Tracking Progress
Your therapist uses the week-by-week progression criteria to decide when you are ready for the next phase, rather than calendar dates alone. Outcome measures—such as the UCLA, ASES, Constant-Murley, DASH, goniometric range of motion, and manual muscle testing—help document change over time and guide adjustments. Report how your shoulder feels between sessions so the plan can be refined safely.
Recovery and Self-Care
Manage discomfort with ice and positioning as advised, and respect rest days. Do not mask increasing pain with activity. Seek prompt clinician advice for worsening pain, sudden loss of motion or strength, swelling, fever, or numbness and tingling. These may signal a problem needing review.
Recovery phases
Passive forward flexion to 90 degrees with glenohumeral joint in neutral rotation,External rotation limited to 0 degrees (at side) to protect repaired rotator cuff,Sling immobilization except for elbow/wrist ROM exercises,Scapular retraction exercises in supine with minimal activation,Pain controlled at <3/10 at rest with ice and positioning,No active glenohumeral motion to protect repaired biceps tendon and labrum
→ Advance to: Phase II - Early Passive Motion
Passive forward flexion increased to 120 degrees,Passive external rotation to 15 degrees with arm in scapular plane,Passive glenohumeral internal rotation in scapular plane at 45 degrees abduction,Active scapular stabilization (scapular retraction/protraction) in sidelying,Pain <2/10 with passive ROM exercises,Continued protection of AC joint from superiorly directed stresses
→ Advance to: Phase II - Early Passive Motion
Passive forward flexion to 145 degrees,Passive external rotation to 30 degrees at 90 degrees abduction,Passive internal rotation to 45 degrees at 90 degrees abduction,Active-assisted ROM using cane or therapist assist for glenohumeral motion,Isometric rotator cuff contractions at neutral (submaximal, pain-free),Pain <2/10 with all exercises, no increase with activity
→ Advance to: Phase III - Active Motion
Active forward flexion to 160 degrees (full available),Active external rotation to 45 degrees at 90 degrees abduction,Active internal rotation to 55 degrees at 90 degrees abduction,Active glenohumeral elevation in scapular plane against gravity (supine),Initiated rotator cuff isometric exercises at 90 degrees abduction,Scapular stabilization exercises in prone (prone Y-T-W exercises)
→ Advance to: Phase IV - Progressive Strengthening
Full active ROM in all planes (forward flexion, abduction, external rotation, internal rotation),Rotator cuff strengthening: external rotation with resistance band at 0 degrees abduction,Rotator cuff strengthening: internal rotation with resistance band at 0 degrees abduction,Biceps tendon strengthening: resisted elbow flexion with light resistance (1-2 lbs),Scapular strengthening: rows, lat pull-downs (light),Pain <1/10 with strengthening exercises
→ Advance to: Phase V - Advanced Strengthening
Rotator cuff strengthening: external/internal rotation at 90 degrees abduction,Progressive resistance for deltoid (weighted scapular plane elevation),Progressive loading for biceps tendon (resisted elbow flexion/forearm supination),Endurance training: repetitive scapular stabilization exercises,Functional movement patterns initiated (reaching, lifting below shoulder level),Patient demonstrating proper scapulohumeral rhythm without substitution patterns
→ Advance to: Discharge to independent maintenance program
Return to activity milestones
Pain-free basic activities of daily living
Week 1Wrist and finger range of motion full; no tenodesis limitation
Light functional activities and conditioning
Week 2Patient demonstrates correct hand therapy exercise technique
Moderate activity and sport-specific conditioning
Week 3Able to complete 5 minutes of light kitchen or desk activity
Full return to sport, occupation, and recreation
Week 6Scapulothoracic rhythm normalised: no winging on wall push-up
Precautions
- warm-up-before
- stop-if-pain-increases
Contraindications
- severe-osteoporosis
- acute-inflammation
- unstable-fixation
- compartment-syndrome
Pain management
- Cryotherapy (ice pack application for 15-20 minutes post-exercise)
- Non-steroidal anti-inflammatory medication (as prescribed)
- TENS (Transcutaneous Electrical Nerve Stimulation) for pain modulation
- Positioning and ergonomic education (sleeping positioning, activity modification)
- Gentle joint mobilizations (Grade I-II glenohumeral) for pain relief
Equipment & modalities
Frequently asked questions
How hard should I push during exercises?
What if I miss a session or a week feels too easy?
Can I use the pull-up bar and weight vest now?
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