Rehabilitation of the post-operative rotator cuff has recently been under debate. While shoulder pulleys have classically been used to improve range of motion and re-establish strength, there has been a rising concern that rope and pulley exercises may be hurting more than helping. The accusation lies in a potential of excessive scapular motion and the damage it may cause during the recovery process.

Should pulleys be used for rotator cuff rehabilitation exercise?

Baumgarten and colleagues set out to bust this myth once and for all. In their study, they theorized:

“Rotator cuff repair patients treated with pulley exercises would have increased scapular substitution and inferior patient-determined outcome scores, range of motion, and strength compared with patients treated with an alternative rehabilitation program without pulleys” (Baumgarten et al. 2016).

A total of 53 patients were chosen to participate in this study. All post-operative rotator cuff repairs, they were randomly divided into two separate groups: 27 to a rehabilitating using pulleys, 26 patients without pulleys. The outcomes of their rehabilitation were measured at weeks 6, 12, 18, 26 and 52, determined by:

  • Patient-determined outcome
  • Range of motion
  • Scapular substitution
  • Strength

Click here for the full rotator cuff rehabilitation protocol

 After the intervention, the researchers confidently determined that “A rotator cuff repair rehabilitation program that uses pulleys does not result in inferior outcomes,” (Baumgarten et al, 2016).

  • Both groups yielded statistically significant improvements in the patient-determined outcome tests.
  • Both interventions demonstrated improvements in shoulder flexion, abduction, external rotation, strength, and scapular substitution over time after rotator cuff repair.
  • There was no difference in range of motion, strength, or scapular substitution between interventions.

Pulley away! If you’re not sure where to start, view our database of shoulder pulley exercises for rehabilitation guidance and inspiration.


Baumgarten KM et al. 2016. Are Pulley Exercises Initiated 6 Weeks After Rotator Cuff Repair a Safe and Effective Rehabilitative Treatment? A Randomized Controlled Trial. Am J Sports Med. 44(7):1844-51

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