FROM MY PT SCHOOL NOTES · MUSCULOSKELETAL · CHAPTER 11
After Shoulder Surgery: Let the Operation Guide Rehabilitation
The 2018 post-surgical lecture contrasts several procedures. The lasting lesson is understanding what tissue was repaired or replaced before deciding which movement is appropriate.
Procedures in the original class material
The lecture covers rotator cuff repair, acromioplasty, biceps tenodesis, SLAP repair, capsulorrhaphy, rotator interval closure and shoulder arthroplasty. Some protect tendon-to-bone repair; others protect a labral/capsular reconstruction or a prosthetic articulation.
Questions before prescribing exercise
Check the exact operation and tendon/labrum/capsule involved, combined procedures, repair quality, surgeon restrictions, sling/brace instructions and allowed passive, assisted, active and resisted movement. Subscapularis repairs may affect early external rotation; biceps procedures affect early biceps loading; anatomic and reverse arthroplasties have different risk profiles.
Why calendar milestones are insufficient
The lecture gives specific week and degree limits, but these are historical examples of particular protocols, not universal standards. An acromioplasty alone and an acromioplasty with cuff repair are not equivalent; neither are two arthroplasties with different approaches and repairs.
Current evidence and collaboration
Use the operative report, surgeon-provided procedure protocol and clinical response. The 2025 AAOS rotator cuff injuries guideline compares early and delayed mobilization for selected small-to-medium arthroscopic full-thickness repairs; it does not establish unrestricted movement for every repair, combined procedure, subscapularis repair or arthroplasty. That is separate from the 2025 nonsurgical tendinopathy guideline.
Try a clinical decision
Two people are four weeks after ‘shoulder surgery.’ One had isolated biceps tenodesis; the other had a cuff plus subscapularis repair. Can they follow the same ROM chart?
No. Verify each operation, associated repairs and restrictions before applying or progressing motion or resistance. Postoperative week alone is not clearance.
Original course sources and limitations
Shoulder Post-Surgical Management (Summer 2018). Detailed surgery diagrams and copied protocol tables are intentionally excluded.
This lesson is distilled from my original PT-school notes, with current external guidance labeled separately. It is not an official course or a substitute for clinical examination and procedure-specific protocols.
