The rotator cuff is crucial for proper function of the shoulder and activities of daily living (ADL). Full-thickness rotator cuff tears require surgical repair and a lengthy recovery, often lasting 6 months or more. Early physical therapy exercises are very conservative, focusing more on allowing the repair to heal. For fear of re-injury, dynamic resistance exercise is sometimes avoided for the first 4 months post-op. Swedish researchers investigated if accelerated rehabilitation after full-thickness rotator cuff tear surgery was safe and beneficial. In their prospective, randomized and controlled trial, one group of 7 patients underwent traditional physical therapy, while another group of 7 patients performed accelerated physical therapy, utilizing dynamic elastic resistance earlier in the rehabilitation protocol. Patients in the accelerated group removed their slings after 4 weeks to begin gentle motion and early strengthening against aquatic resistance. They also initiated elastic resisted internal rotation and external rotation at 8 weeks. Both groups received clinical and home exercise programs. The researchers concluded that the accelerated group had slightly faster recovery than traditional therapy without any adverse effects. While these results are encouraging, further research with more subjects is obviously needed.

Klintberg IH, et al. Early loading in physiotherapy treatment after full-thickness rotator cuff repair: a prospective randomized pilot-study with a two-year follow-up. Clin Rehabil. 2009 Jul;23(7):622-38.

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