Rotator cuff pathology is an extremely common problem in adult patients. While rehabilitation of the postsurgical rotator cuff patient is challenging, it is a problem best managed with the combined input of the patient, therapist, and treating orthopaedic surgeon. Rehabilitation protocols should respect the balance between risk of rotator cuff retear from early aggressive therapy and the development of shoulder scarring and stiffness from prolonged demobilization. It should progress at a pace that prevents shoulder stiffness, but respects the timelines of tendon healing biology. The purpose of this article is to provide an evidence-based approach, using the available basic science and clinical literature, to illustrate rehabilitation guidelines after surgical repair of the rotator cuff.
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