This document is a detailed, phase‑based postoperative rehabilitation protocol for patients who have undergone a Type III rotator cuff repair (arthroscopic‑assisted mini‑open) for large to massive tears (>4 cm). It is organized into five sequential phases spanning Day 1 through Week 30, each with explicit goals, timelines, and exercise progressions. Phase I (Day 1‑10) focuses on protecting the repair, initiating passive and active‑assisted range of motion, pain control with cryotherapy, and strict bracing precautions. Phase II (Day 11‑Week 6) emphasizes soft‑tissue healing, gradual restoration of full passive ROM, dynamic shoulder stability, and the introduction of isotonic strengthening, tubing exercises, and pool work. Phase III (Week 7‑14) aims for full active ROM, continued dynamic stabilization, and progressive isotonic strengthening while ensuring the patient can elevate without scapular hiking. Phase IV (Week 15‑22) concentrates on maintaining non‑painful ROM, enhancing functional upper‑extremity use, and building muscular strength and power. Phase V (Week 23‑30) guides a gradual return to strenuous work and recreational sports, with a home exercise program and optional interval sport activities. Throughout, the protocol lists precise ROM targets (e.g., flexion to 125°, ER/IR to 35‑45°), frequency of modalities (ice 6‑7 times daily, heat prior to ROM), brace usage instructions, and a set of precautions to avoid over‑stress, lifting, aggressive stretching, or weight‑bearing through the hands. The document concludes with copyright notices and a disclaimer on redistribution.
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Phase I – Immediate Post‑Surgical Phase (Day 1‑10): Protection and Early Motion
Outlines goals to maintain repair integrity, pain control, and gradual passive ROM; details daily exercises, pendulum, L‑Bar assisted ROM, isometrics, and cryotherapy; specifies brace/sling usage and sleeping position.