and Reading
Rehabilitation Protocols

Shoulder and Upper Extremity
Research Group of Edmonton (SURGE)

SURGE undertakes clinical research to improve patient care and outcomes for those with upper extremity conditions or injuries. Upper extremity refers to the shoulder, elbow, wrist or hand. The SURGE team consists of researchers, physical therapists, orthopedic surgeons and sports medicine physicians.

How does SURGE improve patient care and outcomes?

  • Evaluating new and existing operative and non-operative interventions
  • Providing information and implementing findings through workshops and conference presentations
  • Developing treatment guidelines for common upper-body injuries

Below is a link to the shoulder rehabilitation treatment guidelines developed by SURGE. These include both post-operative and non-operative treatment guidelines.


SURGE Non-Operative Rotator Cuff-Related Shoulder Rehabilitation Guidelines

The EBJC Shoulder Assessment Clinic strongly encourages physical therapists to use the non-operative rotator cuff-related shoulder guidelines to manage their patients with rotator cuff-related pain and/or dysfunction. This includes patients with massive rotator cuff tears who are able to elevate their shoulder above 90 degrees.

Treatment should be primarily exercise-based. Once patients can perform exercises independently, they should do so at home at least 4 days/week with periodic follow-up to assess changes and progress their home-based program. Patients should be educated that exercise is important for long term management of their symptoms. Discontinuation of their home exercise program can result in a recurrence of symptoms and a decline in function.

The Reading Protocol

The Reading Protocol is a rehabilitation program for patients with massive rotator cuff tears who are unable to elevate their arm above 90 degrees. This program is an anterior deltoid re-education/strengthening program designed by the Shoulder and Elbow Centre Reading Shoulder Unit in the UK by Dr. S. Copeland and Dr. O. Levy. The EBJC Shoulder Assessment Clinic recommends using this protocol in this patient population.