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Rehabilitation of the Rotator Cuff: An Evaluation-Based Approach

Dr. Millett is Assistant Professor of Orthopedics, Harvard Medical School, Boston, MA, and Director of Shoulder Surgery, Steadman Hawkins Clinic, Vail, CO. Dr. Wilcox is Clinical Supervisor, Outpatient Services, Department of Rehabilitation Services, and Fellow, Center for Evidence Based Imaging, Department of Radiology, Brigham and Women’s Hospital, Boston. Dr. O’Holleran is Fellow, Harvard Shoulder Service, Brigham and Women’s Hospital/Massachusetts General Hospital. Dr. Warner is Professor of Orthopedics, Harvard Medical School, Chief, Harvard Shoulder Service, and Orthopedic Surgeon, Department of Orthopedics, Massachusetts General Hospital.

None of the following authors or the departments with which they are affiliated has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Millett, Dr. Wilcox, Dr. O’Holleran, and Dr. Warner.

Reprint requests: Dr. Millett, Steadman Hawkins Research Foundation, Suite 1000, 181 West Meadow Drive, Vail, CO 81657.

Rotator cuff disease of the shoulder, a common condition, is often incapacitating. Whether nonsurgical or surgical, successful management of rotator cuff disease is dependent on appropriate rehabilitation. Numerous rehabilitation protocols for the management of rotator cuff disease are based primarily on anecdotal clinical observation. The available literature on shoulder rehabilitation, in conjunction with clinical observation that takes into consideration the underlying tissue quality and structural integrity of the rotator cuff, can be compiled into a set of rehabilitation guidelines. The four phases of rehabilitation begin with maintaining and protecting the repair in the immediate postoperative period, followed by progression from early passive range of motion through return to preoperative levels of function.

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