Rotator Cuff Surgery Rehab: Physio Timeline Week by Week
Tom didn’t think much of his shoulder pain at first. It would flare up when he reached overhead
or tried lifting heavier things, but he figured he’d pulled a muscle. When the pain got worse and
lifting a mug of coffee became a challenge, he finally went for help.
He was diagnosed with a torn rotator cuff, and surgery was the only option.
But here’s what surprised Tom most: not the operation, but what came after: the long, careful
rehab process.
Regaining movement and strength isn’t instant, but a steady climb, one week at a time. And ifyou’re preparing for rotator cuff surgery, or already recovering, this guide breaks down the
physiotherapy timeline in a simple, clear way so you know exactly what to expect.
Week 1 to 2: Rest, Ice, and Protect
Right after surgery, your shoulder will be sore, swollen, and off-limits for real movement. Your
arm will likely be in a sling 24/7 (even during sleep). And while that sling may feel annoying, it’s
your best ally at the time.
The main goals during this early phase are:
● Protect the surgical repair
● Reduce swelling with ice and elevation
● Avoid movement of the shoulder unless instructed by your surgeon
Your physiotherapist might start with passive range of motion (PROM) exercises: very gentle
stretches where they gently move your arm for you, without your muscles doing any of the work.
According to the Cleveland Clinic, early passive movement helps prevent stiffness without
stressing the surgical repair.
Small tip: Start moving your wrist and fingers often, and practice good posture. It helps prevent
stiffness in other areas while your shoulder rests.
Week 3 to 6: Gentle Mobility Begins
Pain is typically more manageable, but your sling may still be part of your routine. This is when you do passive and assisted range of motion to start regaining movement, slowly and safely.
What you’ll likely work on:
● Pendulum swings: Let your arm dangle and move in gentle circles
● Table slides and wall crawls: Help your shoulder begin lifting again
● Elbow, wrist, and hand mobility to keep the rest of your arm active is the key here. You’re still not allowed to use your shoulder muscles to lift or push.
Your physio will guide you every step so you don’t do too much or too fast.
Week 7 to 10: Starting Active Motion
You can now begin actively moving your arm without assistance, but still with no resistance.You might feel weak, and that’s normal. It’s part of the process.
Expect your therapist to start:
● Shoulder raises within a safe range
● Isometric holds: activating muscles without moving the joint
● Continued range of motion exercises
This phase can feel like slow progress, but trust it, as every extra inch of movement counts.
Week 11 to 16: Strength Training Phase
Now for the fun part: getting stronger. Your shoulder’s finally ready for light resistance and
strength-rebuilding.
Expect exercises like:
● Resistance bands routines for rotator cuff and shoulder stability
● Scapular stabilization exercises to support shoulder movement
● Core and posture training to support body mechanics
Daily tasks like brushing your hair or reaching into a cabinet start getting easier. Just don’t rush. Your shoulder still needs time and consistency.
“One of the most common mistakes we see as physiotherapist’s is patients returning to lifting or sports too soon,” says Lalitha, who practices physiotherapy in Calgary at Brentwood Physio. “Progress might feel slow, but if you respect the timeline, you’ll come back stronger than before.”
Important: Pain is a signal. If something hurts, stop and reassess with your therapist.
Month 4 and Beyond: Return to Full Function
At this point, your shoulder has likely regained strength, control, and nearly full mobility. But full healing takes 6 to 12 months, depending on your lifestyle and the severity of your tear.
If you’re returning to intense activity or physical work, your physiotherapist may add:
● Plyometric movements like medicine ball tosses
● Advanced strength drills for endurance
● Sport-specific or work-simulated movement training
You may still feel some stiffness at the end of a busy day, but with continued home exercises, you’ll keep progressing.
We interviewed Elizabeth Sutton owner of Peak PT who said “timelines can vary, and it’s not always linear. “Depending on the surgeon—because many are still immobilizing in the first few weeks—patients often rely on ice or a cryo pack and a lot of Netflix and chill,” says a therapist at
Axis Toronto. “Once patients are allowed to move, they usually have to use something else to assist the arm, like a stick or gravity—Assisted Living. Then the next phase usually indicates progressive resisted exercises—Resistance is Utile. Final phases, especially for those in
physically demanding jobs or sports, can extend past 20 weeks and focus on overhead and speed work. Because it can take so long: Patience is a Virtue.”
A Few Final Thoughts
Tom stayed committed, even on the tough days when his arm felt heavy and progress seemed slow. Eight months later, he could lift, reach, and sleep on his side again, without pain. That’s the magic of physiotherapy. It isn’t just about “healing” but building your body back better
than before.
So if you’re staring down a long recovery, don’t worry. You’ve got a map now. And with a little patience and the right guidance, your shoulder’s comeback story is already in motion.
