Rotator Cuff Surgery Recovery: Week-by-Week Exercise Guide
Understanding Rotator Cuff Repair
Rotator cuff surgery repairs torn tendons in your shoulder. Recovery is long—typically 4-6 months for basic function, up to a year for full recovery.
Key points:
Protocols vary based on tear size, repair quality, and surgeon preference. Always follow your surgeon's specific instructions.
The Recovery Timeline
Phase 1: Protection (Weeks 0-6)
Phase 2: Early Motion (Weeks 6-12)
Phase 3: Strengthening (Weeks 12-20)
Phase 4: Advanced Strengthening (Weeks 20+)
Phase 1: Protection (Weeks 0-6)
Goals
Exercises
Pendulum Exercises (Codman's)
1. Lean forward, supporting yourself with good arm
2. Let affected arm hang relaxed
3. Gently swing arm in small circles
4. Clockwise and counterclockwise
5. Forward/back, side to side
6. 2-3 minutes, 3-4 times daily
Elbow Flexion/Extension
1. Out of sling
2. Bend and straighten elbow
3. 10-15 repetitions, several times daily
Wrist and Hand Exercises
1. Make a fist, open hand
2. Wrist circles
3. Finger movements
4. Prevents stiffness, promotes circulation
Passive External Rotation (with therapist or per protocol)
1. Lie on back
2. Elbow at side, bent 90°
3. Use stick or other arm to rotate forearm outward
4. Only as directed by your surgeon/PT
Passive Forward Flexion (supine)
1. Lie on back
2. Use other arm or stick to lift affected arm overhead
3. Only to range allowed by surgeon
4. No active lifting
Precautions
Phase 2: Early Motion (Weeks 6-12)
Goals
Exercises
Active-Assisted Flexion
1. Use pulley system or other arm to help
2. Raise arm overhead with assistance
3. Progress to less assistance over time
4. 10-15 repetitions, 2-3 times daily
Active-Assisted External Rotation
1. Hold stick with both hands
2. Push affected arm outward using good arm
3. 10-15 repetitions
Wall Walks (Flexion)
1. Face wall
2. Walk fingers up wall, raising arm
3. Use fingers to assist, not just shoulder muscles
4. Progress higher over time
Wall Walks (Abduction)
1. Stand sideways to wall
2. Walk fingers up wall to side
3. Progress range over time
Supine Active Flexion
1. Lie on back
2. Raise arm toward ceiling (gravity eliminated)
3. Progress range over time
Isometrics (if approved)
Gentle muscle activation without movement:
1. External rotation against wall
2. Internal rotation against wall
3. Hold 5-10 seconds, low intensity
Phase 3: Strengthening (Weeks 12-20)
Goals
Exercises
Active Range of Motion
All directions without assistance:
Rotator Cuff Strengthening
External Rotation with Band
1. Elbow at side, bent 90°
2. Hold band
3. Rotate forearm outward against resistance
4. 15 repetitions, 2-3 sets
Internal Rotation with Band
1. Elbow at side, bent 90°
2. Hold band anchored to side
3. Rotate forearm inward against resistance
4. 15 repetitions, 2-3 sets
Side-Lying External Rotation
1. Lie on uninvolved side
2. Affected arm on top, elbow bent
3. Hold light weight
4. Rotate forearm toward ceiling
5. 15 repetitions, 2-3 sets
Prone Y-T-W
1. Lie face down on bench or bed
2. Y: Raise arms at 45° angle, thumbs up
3. T: Raise arms straight to sides
4. W: Elbows bent, squeeze shoulder blades
5. 10 repetitions each position
Rows
1. Band or cable
2. Pull elbows back
3. Squeeze shoulder blades
4. 15 repetitions, 2-3 sets
Scapular Exercises
Phase 4: Advanced Strengthening (Weeks 20+)
Goals
Exercises
Progress resistance on all previous exercises
Shoulder Press (when cleared)
1. Light weight initially
2. Press overhead
3. Progress weight gradually
Lat Pulldowns
1. Light weight
2. Progress range and weight
Push-Ups (progression)
1. Wall push-ups
2. Incline push-ups
3. Knee push-ups
4. Full push-ups (much later)
Sport-Specific Training
Common Mistakes to Avoid
1. Progressing too fast — The repair can re-tear
2. Skipping exercises — Stiffness is hard to reverse
3. Using arm to push up from chair/bed — Stresses repair
4. Sleeping on surgical side — Wait until cleared
5. Lifting too early — Follow weight restrictions strictly
6. Ignoring pain — Some discomfort is normal; sharp pain is not
What to Expect
Pain
Stiffness
Timeline to Activities
When to Call Your Surgeon
The Bottom Line
Rotator cuff recovery requires patience:
1. Protect the repair early (Phase 1)
2. Restore motion before strength (Phase 2)
3. Strengthen progressively (Phases 3-4)
4. Follow your surgeon's specific protocol
5. Work with a physical therapist
6. Don't rush—re-tears happen when you do too much too soon
Full recovery takes time, but most people return to their activities.
Foundational Rehab provides shoulder rehabilitation programs aligned with post-surgical protocols.