Howdy,

Rotator cuff repair sounds like not a big deal, but you need to be very careful when starting rehab, as repair failure isn’t that rare – particularly in elderly population. This is why I wanted to mention these 3 surprising (and very important) things:

1. Avoid opening heavy doors with the NON-SURGICAL side. Heavier pulling with the contralateral arm has shown EMG as high as 32% on the surgical side supraspinatus (Smith et al. JSES 2004). This is the one not many people think about, but indeed – the cross-educational effect is real (but this time in a negative way);
2. Avoid fast forward arm movements with the NON-SURGICAL side. This has been shown to produce EMG as high as 57% on the surgical side infraspinatus (Smith et al. JSES 2004). So, avoid heavy or fast pushing as well;
3. Avoid “pendulum” performed incorrectly. When performed incorrectly, large pendulums elicit >15% MVIC on the cuff as well (Long et al. JOSPT 2010). This usually means moving aggressively with increased range of motion (more than recommendable). PS: Everything above 20% MVIC is considered risky in the beginning of rehab (often even first 6 weeks post-op).

The most important goal of this post is to bring more of your attention to these important details. I hope this info will help your initial rehab plan, from the safety standpoint at least.

Yours in progression,

Luka