Rebuilding Shoulder Reach After a Rotator Cuff Repair

A 52-year-old office worker is ten weeks after rotator cuff repair and can dress comfortably, but reaching into a high cupboard still feels stiff and uncertain. How would you progress the shoulder without losing the protection the healing tissue needs? Review the surgical guidance first, then observe what the movement reveals. Does the scapula rotate early, does the trunk lean away, or does the person hold the breath to avoid discomfort? Begin with active assisted range, scapular control, and gentle isometric work in a pain-free zone. Progress toward shoulder flexion and external rotation with attention to rib position and neck relaxation. Add elbow and wrist mobility so the hand can reach without forcing the shoulder. Later, introduce light load in patterns that resemble daily tasks: lifting a kettle, placing a plate, or reaching for a seatbelt. Use pain, swelling, and quality of motion as guides, but measure progress with clear functional goals. Explain the difference between stiffness and strain, and give the patient a simple way to report changes between visits.