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A randomized clinical trial evaluated whether patients could safely begin pain-free active shoulder motion within the first six weeks after arthroscopic rotator cuff repair rather than remaining completely immobilized. More than 200 patients with full-thickness tears were followed for two years. Early mobilisation produced better flexion and abduction at six weeks, but later range of motion, pain, strength and quality of life were similar between groups. Ultrasound at 12 months also showed comparable repair integrity. These results suggest that carefully prescribed early motion can accelerate early functional recovery without compromising tendon healing in many patients. For HCPs, the message is not to abandon protection of the repair, but to move away from unnecessarily rigid immobilisation. Patient selection matters, and large or poor-quality tears may warrant a more conservative progression. The evidence supports shared rehabilitation planning in which movement is introduced within safe limits and gradually progressed. For surgeons, physiotherapists and patients, the study provides reassurance that a balanced approach can reduce early stiffness while maintaining acceptable structural outcomes.

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A randomized clinical trial evaluated whether patients could safely begin pain-free active shoulder motion within the first six weeks after arthroscopic rotator cuff repair rather than remaining completely immobilized. More than 200 patients with full-thickness tears were followed for two years. Early mobilisation produced better flexion and abduction at six weeks, but later range of motion, pain, strength and quality of life were similar between groups. Ultrasound at 12 months also showed comparable repair integrity. These results suggest that carefully prescribed early motion can accelerate early functional recovery without compromising tendon healing in many patients. For HCPs, the message is not to abandon protection of the repair, but to move away from unnecessarily rigid immobilisation. Patient selection matters, and large or poor-quality tears may warrant a more conservative progression. The evidence supports shared rehabilitation planning in which movement is introduced within safe limits and gradually progressed. For surgeons, physiotherapists and patients, the study provides reassurance that a balanced approach can reduce early stiffness while maintaining acceptable structural outcomes.
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