Efficacy of Adding Early Scapular Muscles Strengthening Exercise After Rotator Cuff Repair on Scapula Kinematics

The study will consist of two groups, each participating in an accelerated rehabilitation program that will start in the first week after surgery and continue until week 12. However, the groups will follow different protocols. The first group will follow an accelerated rehabilitation protocol with early strengthening of the scapular stabilizer muscles, specifically the lower trapezius (LT) and serratus anterior (SA). This group will begin gradual active range of motion (ROM) for the glenohumeral (GH) joint from week 4 post-operative until week 12, as well as scapular muscle strengthening exercises starting from the first week. The second group will follow a protocol with delayed strengthening of the scapular stabilizer muscles. In this group, active ROM for the GH joint and scapular activation exercises (including protraction, retraction, and depression) will begin from week 6 and continue until week 12. Patients will be required to wear a sling for the first 6 weeks or as recommended by the physician, removing it only during therapy sessions and home exercises. Outcomes will be measured at three points: at week 3 for baseline assessment, and then reassessed at weeks 6 and 12.