Post-Op Shoulder Rehabilitation

Shoulder surgery — whether rotator cuff repair, labral repair, shoulder replacement, or decompression — requires careful, progressive rehabilitation to achieve optimal results. The shoulder is a uniquely mobile joint, and restoring full function requires a precise balance between protecting the surgical repair and advancing range of motion and strength in a timely manner.

Common shoulder surgeries that require post-operative physical therapy include:

• Rotator cuff repair — arthroscopic or open repair of torn tendon tissue
• Labral repair (SLAP or Bankart) — stabilization of the cartilage rim of the shoulder socket
• Total or reverse shoulder replacement — joint replacement for severe arthritis or irreparable rotator cuff tears
• Subacromial decompression — removal of bone spurs or tissue to create more space for the rotator cuff
• Shoulder stabilization — surgical correction for recurrent dislocations
• Biceps tenodesis — reattachment of the biceps tendon to the upper arm bone

Rehabilitation timelines and protocols vary significantly by procedure. Your therapist will follow the specific protocol from your surgeon while adapting treatment to your individual progress, ensuring the repair is protected while recovery moves forward on schedule.

Post-operative shoulder rehabilitation at The Back Clinic typically progresses through four phases, each with specific goals and progression criteria:

• Phase 1: Protection (weeks 0–6) — Gentle passive range of motion within surgeon-specified limits, pain and swelling management, scar care, and education on sling use and movement precautions
• Phase 2: Active Motion (weeks 6–12) — Progressive active-assisted and active range of motion as tissue healing permits, beginning of light isometric and early strengthening exercises
• Phase 3: Strengthening (weeks 12–20) — Progressive rotator cuff and scapular stabilizer strengthening, functional movement training, and gradual return to overhead activities
• Phase 4: Return to Activity (weeks 20+) — Sport-specific or job-specific training, full functional integration, and clearance testing for unrestricted activity

Throughout each phase, your therapist provides hands-on manual therapy to optimize tissue healing, restore joint mobility, and manage scar tissue formation that can limit range of motion if not addressed.

Every session at The Back Clinic is one-on-one with your physical therapist — never handed off to aides or shared with other patients. This is especially critical after shoulder surgery, where precise hands-on mobilization and careful monitoring of tissue response are essential to achieving the best possible outcome.

Post-surgical shoulder rehabilitation is a long-term commitment — most protocols span four to six months, and some complex repairs may require up to a year of progressive rehabilitation. Your therapist will set clear expectations for each phase, explain what milestones to look for, and keep you informed of your progress throughout.

We typically see patients two to three times per week in the early phases, transitioning to one to two times per week as you become more independent with your exercise program. Home exercises are a critical component at every stage — your therapist will ensure you know exactly what to do between sessions.

We communicate directly with your surgeon at key milestones to confirm advancement through protocol phases and to report any concerns. This collaborative approach ensures everyone on your care team is aligned on your progress and plan.

Most insurance plans, including Medicare, cover post-surgical physical therapy. You do not need a referral to start treatment in Delaware. Call (302) 529-1900 or schedule online to book your first post-operative visit.