Intermediate Shoulder Tendon Repair Rehabilitation

Passive forward flexion to 90 degrees with glenohumeral joint in scapular plane,External rotation limited to 0 degrees with arm in scapular plane,Active elbow flexion and wrist movement without shoulder compensation,Sternal sleeping position maintained without pressure on repaired structures,Scapular stabilization with gentle scapular setting exercises,Pain less than 3/10 at rest and during supervised ROM

→ Advance to: Week 2-3: Protected Motion Phase

Passive forward flexion to 120 degrees in glenohumeral rhythm,Passive external rotation to 15 degrees at 90 degrees abduction,Active-assisted ROM with pendulums and supine flexion,Isometric rotator cuff contractions at neutral rotation,Scapular protraction and retraction against gravity,Pain less than 2/10 during all exercises

→ Advance to: Week 3: Early Passive Motion Phase

Passive forward flexion to 145 degrees with proper glenohumeral-scapular motion,Passive external rotation to 30 degrees at 90 degrees abduction,Passive internal rotation to 70 degrees,Active-assisted ROM progressing to active flexion,Rotator cuff isometrics at multiple angles,Scapular control during all shoulder movements

→ Advance to: Week 4-6: Active Motion Phase

Active forward flexion to 160 degrees with normal scapulohumeral rhythm,Active external rotation to 45 degrees at 90 degrees abduction,Full passive internal rotation with glenohumeral distraction,Active shoulder abduction to 120 degrees,Beginning rotator cuff isotonic strengthening at limited angles,Scapular strengthening in prone positioning

→ Advance to: Week 5-6: Early Strengthening Phase

Full active forward flexion against gravity,External rotation to 60 degrees at 90 degrees abduction,Internal rotation to 70 degrees at 90 degrees abduction,Rotator cuff strengthening at 0 degrees abduction,Biceps curls with light resistance 2-3 kg,Scapular exercises with Theraband resistance

→ Advance to: Week 6: Strengthening Progression

Full ROM in all planes with proper glenohumeral mechanics,External rotation strength 4/5 against resistance,Internal rotation strength 4/5 against resistance,Supraspinatus isolation at 30 degrees abduction,Scapular control during loaded arm positions,Pain-free resistance training at 25% capacity

→ Advance to: Week 7-9: Moderate Strengthening Phase

Full rotator cuff strengthening in all planes,External rotation at 90 degrees abduction to 90 degrees,Progressive resistance training 40-50% 1RM,Proprioceptive exercises on unstable surfaces,Functional reaching movements at waist to shoulder height,Scapular loading exercises with increased resistance

→ Advance to: Week 8-9: Advanced Strengthening Phase

Rotator cuff strengthening at 70% capacity,External and internal rotation at multiple angles,Proprioceptive training with eyes closed,Overhead activities to 120 degrees,Progressive scapular stabilization under load,Endurance training for rotator cuff musculature

→ Advance to: Week 9: Sport-Specific Preparation

Full strength 70-80% bilateral comparison,Overhead throwing progression initiation,Power development for rotator cuff,Agility exercises with shoulder loading,Sport-specific movement patterns,Endurance maintenance for shoulder girdle

→ Advance to: Week 10-11: Return to Activity Phase

Isokinetic testing at 180 degrees per second,Sport-specific skill progression,Plyometric progressions for upper extremity,Shoulder endurance matching contralateral side,Full training volume tolerance,Confidence in dynamic shoulder stability

→ Advance to: Week 11: Full Return Progression

Unrestricted ROM with normal arthrokinematics,Strength 85-90% of contralateral side,Full training and competition exposure,Tolerance of high-velocity movements,Psychological readiness for full return,No reactive swelling with activity

→ Advance to: Week 12: Discharge Criteria

Full pain-free ROM in all planes,Strength 90%+ of contralateral side,Passed functional movement screen,Completed sport-specific progression,Independent home exercise program,Follow-up appointment scheduled

→ Advance to: Discharge