Department of rehabilitation services physical therapy arthroscopic rotator cuff repair protocol. Rotator cuff repair postsurgical rehabilitation protocol postop days 1 21 immobilizer with abductor pillow x 46 weeks even while sleeping place pillow under shoulder arm while sleeping for comfort hand squeezing exercises elbow and wrist active motion arom with shoulder in neutral position at side. Rehabilitation guidelines for rotator cuff repair and isolated subscapularis repair 2 uwsportsmedicine. The novocaine in your shoulder wears off in about six hours. Initiate manual resistance er in supine in scapular plane light resistance. It is not intended to be a substitute for clinical decision making. The rotator cuff is the key to elevation of the upper extremity. The intent of this protocol is to provide the therapist and patient with guidelines for the postoperative rehabilitation course after arthroscopic rotator cuff repair. Pdf background rotator cuff tears are a very common condition that is. Arthroscopic rotator cuff repair rtc with biceps tenodesis rehab you have had an arthroscopic rotator cuff repair, and therefore the rehabilitation is significantly different from patients that have had an open or miniopen procedure. Before we talk about treatment, lets start with a discussion about the human. It causes tendons to become irritated or rotator cuff tendonitis, also known as impingement syndrome, is a condition that affe. Resistance exercise should not be performed with specific shoulder joint pain or.
The shoulder is a wonderfully complex joint that is made up of the ball and socket connection between the humerus ball and the glenoid portion of the scapula socket. The intent of this protocol is to provide the clinician with a. This protocol might be adjusted for patients on an individual basis. The goal of these videos is to help maximize your recovery following rotator cuff surgery. General time frames are given for reference to the average, but individual patients will progress at. The principles of crosseducation can be used early in the rehabilitation phase. Rehabilitation protocol for rotator cuff repair small to medium. The literature on rotator cuff repair is voluminous, and what it shows is clear. Rotator cuff repair rehab guidelines small tear isolated supraspinatus 1 anchor procedure. The conservative rehabilitation protocol allows sharpey fibers to form before stressing the repair with resistive exercises. A rotator cuff tear or impingement isnt pleasant, but there are therap. The prevalence of full thickness tears in the general population is about 20% and markedly increased after the age of 50. Rotator cuff tendonitis, also known as impingement syndrome, is a condition that affects the muscles and tendons.
Background the rotator cuff is responsible for stabilization and active movement of the glenohumeral joint. The intent of this protocol is to provide the clinician with a general guideline of the post operative course of the patient that has undergone the above stated procedure. The intent of this protocol is to provide the clinician with a guideline to establish and progress a patient through post operative rehabilitation. Mar 11, 2019 rehabilitation protocol for rotator cuff repair small to medium sized tears this protocol is intended to guide clinicians and patients through the postoperative course of a rotator cuff repair. Specific interventions should be based on the needs of the individual and should consider exam findings and clinical decision making.
Progression of arom against gravity and duration of sling use is predicated both on the size of tear and quality of tissue and should be guided by referring physician. Rehabilitation guidelines for type i and type ii rotator cuff. Postoperative rotator cuff repair protocol therapist instructions immediate therapy the moon shoulder group is a collection of shoulder experts who study the best methodsto treat patients with rotator cu. The conservative approach may be associated with postoperative stiffness which can be managed once healing has occurred. Isometrics targeting the rotator cuff of the unoperated arm e. Rotator cuff repair postoperative rehabilitation protocol. Postoperative rotator cuff repair rehabilitation protocol. An acute or overuse injury may cause the rotator cuff to be injured and varying widths of tears may cause increased pain and dysfunction of the shoulder joint. Rehabilitation after rotator cuff repair of the shoulder. Arthroscopic and open rotator cuff repair rehabilitation protocol week 1 2 shoulder sling and swathe full time day and night.
The rotator cuff is the group of four tendons that stabilize the shoulder joint. Welcome to our rotator cuff repair rehabilitation video series. Rotator cuff and shoulder conditioning program orthoinfo. Subscribe to our free newsletters to receive latest health news and alerts to your email inbox.
A small size rotator cuff tear is definedas a tear repair guideline. Its a group of tendons and muscles that also keep the head of your upper arm bone securely in its socket. Continue with end range stretching and manual therapy as needed. Considerations for the postoperative rotator cuff repair rehabilitation program. We continue to monitor covid19 cases in our area and providers will notify you if there are scheduling changes. It functions to center the humeral head in the glenoid by providing a compressive force with active movement. Rotator cuff repair most rotator cuff tears can be repaired surgically by reattaching the torn tendons to the humerus. Rotator cuff repair large to massive 5cm rehabilitation. Rotator cuff tendonitis symptoms, causes, treatments new life ticket.
Protect the integrity of the repair reduce pain and edema postsurgery maintain grip strength continue to stay in sling until 34 weeks postsurgery. Rotator cuff definition defined by arthritishealth. A large size rotator cuff tear is defined as a tear 3 5cm. Rotator cuff repair rotator cuff repair subacromial decompression distal clavicle excision phase i passive weeks 24. Subscapularis the rotator cuff muscles help raise the arm in the air and rotate the arm. Healing is a biologic process that must be respected and cannot be rushed. Rotator cuff repair massachusetts general hospital. Repair guideline background the rotator cuff is responsible for stabilization and active movement of the glenohumeral joint. A small size rotator cuff tear is definedas a tear rotator cuff muscles are called the. The rotator cuff is a set of muscles that extend from the scapula shoulder blade and attach to the t. Tendon healing back to bone is a slow process that requires many weeks under tension free conditions. Womens health may earn commission from the links on this page, but we only feature products we believe in.
Plymouth rotator cuff repair rehabilitation protocol. A large size rotator cuff tear is defined as a tear 35cm. It is designed for rehabilitation following small to medium rotator cuff repairs. Cole,md,mba range of motion immobilizer exercises phase i 04 weeks 02 weeks. Progression of resistive exercise and rom is dependent on patient tolerance. Davies, dpt professor at armstrong atlantic state university. Failed rotator cuff repairs johns hopkins shoulder and elbow surgery. Rehabilitation guidelines for arthroscopic small rotator. Pdf rehabilitation after arthroscopic rotator cuff. If pain, weakness, and stiffness in your shoulder see figure in appendix are related to problems with your rotator cuff, a doctor will usually first recommend nonsurgical treatment. Jan 01, 2016 the main goals of rehabilitation exercise after rotator cuff repair are return to daily activities, control of pain and inflammation, healing of tendons, movement of subacromial structures and. After an injury or surgery, an exercise conditioning program will help you return to daily.
Postoperative rotator cuff repair protocol therapist. The glsm rotator cuff repair rehabilitation program is an evidencebased and soft tissue healing dependent program. This can occur if the tendons are strained, inflamed, torn, or experiencing degeneration from aging. Rotator cuff repair small to medium rehabilitation guideline. Your rotator cuff surrounds and protects your shoulder joint. Our expert shoulder surgeons provide answers to some of the most frequently asked questions about failed rotator cuff repairs.
Phase 1 maximum protection phase 2 active range of motion. This means a camera and instruments are placed into the shoulder joint through small incisions and used to repair the rotator cuff. The rotator cuff is a set of muscles that extend from the scapula shoulder blade and attach to the top of the humerus upper arm bone. Premier approaches to arthroscopic rotator cuff repair slack books. Rotator cuff repair rehab guidelines medium tear generally involves supraspinatus and infraspinatus partially unstable 23 anchors procedure. The best treatment for rotator cuff repair in the first 3 months is rest. Rotator cuff repair rehabilitation guide matthew boes md. Postoperative rehabilitation protocol rotator cuff repair. Rotator cuff repair rehabilitation protocol the following document is an evidencebased protocol for arthroscopic rotator cuff repair rehabilitation. Your rotator cuff connects your arm bone to your shoulder blade. Most rotator cuff tears can be repaired surgically by reattaching the torn tendons to the humerus.
The socket portion of the joint is not naturally deep. It is not intended to be a substitute for ones clinical decision making. Initiate with submax, pain free isometrics and arom with emphasis on quality. The rotator cuff is responsible for stabilization and active movement of the glenohumeral joint. Keep the abductor pillow in for the 4 weeks as well. The intent of this protocol is to provide the patient, clinician and physical therapist with a guideline of the postoperative rehabilitation course of a patient that has undergone an arthroscopic rotator cuff repair. Use a weight that makes the last few repetitions difficult, but pain free. Pictures courtesy of simpleset, used with permission. A person with rotator cuff problems can experience pain in the shoulder. Rotator cuff disease refers to any damage done to the rotator cuff. Toc rotator cuff rehabilitation protocol medium tear the toc rotator cuff repair rehabilitation program is an evidencebased and soft tissue healing dependant protocol compiled by george j. Rotator cuff repair large to massive 5cm rehabilitation guideline this rehabilitation program is designed to return the individual to their activities as quickly and safely as possible. Purpose of the abductor pillow is to keep tension off of the repair, avoid adduction. The rotator cuff is a combination of muscles and tendons that link your upper arm bone, the humerus, to.
All patients will undergo six to nine months of rehabilitation, divided into phases, focusing on slowly progressing you back to your daily activities, hobbies, and sports. The criteria to progress from phase i to phase ii is a pain free passive motion. Minor strain injuries can progress to a partial tear of the tend. A small size rotator cuff tear is defined as a tear rotator cuff repair is performed, either arthroscopically or via miniopen procedure, by suturing the torn tendon to the. Sep 29, 2017 conservativelarge rotator cuff repair protocol week one weeks two to three initial evaluation evaluate posture and position of the shoulder girdle passive range of motion inspect for signs of infection, and ensure integrity of the incision assess rtw and sport expectations support physician prescribed meds.
M nternational ournal of vo et al, int phys med rehabil. Sling immobilization with supporting abduction pillow to be worn at all times except for showering and rehab under guidance of pt. Rehabilitation guidelines for arthroscopic massive rotator. Exercises you can do at home exercises are a very important part of treatment for a rotator cuff disorder. Rehabilitation protocol for rotator cuff repairsmall to. Pdf rehabilitation after rotator cuff repair researchgate. Rotator cuff rehabilitation protocol rotator cuff repair is a well proven and durable operation which results in decreased pain, improved strength and range of motion for many years after surgery. Rotator cuff strains, even rotator cuff tears can do very well with conservative management that consists of education and exercise. David lintner, md tracey baker mspt and kim broderick mspt atc. Rotator cuff repair protocol south shore orthopedics. Rehabilitation guidelines for type i and type ii rotator.
Rotator cuff surgery can also be performed via a larger open incision but is rarely used and only. Rehabilitation introduction rotator cuff pathology is a common cause of shoulder pain, weakness, limitations to daily activity, and time off from work 1,2. Extended side angle pose stabilizes the shoulder and realigns muscles around the rotator cuff. It is designed for rehabilitation following large to massive rotator cuff repairs. Rotator cuff repair rehabilitation protocol arthroscopic repair note to therapists. The progression through these phases is dependent on factors. Rotator cuff repair rehabilitation protocol arthroscopic. The success of the rotator cuff repair depends on many factors including tear size, tissue. Rotator cuff damage can occur from an acute injury or repetitive wear and tear to the tendons. Rehabilitation guidelines for arthroscopic small rotator cuff. However the torn tendon has a poor blood supply and is frequently weaker than healthy tissue. Slack books, a practical reference guide for orthopedic surgeons, fellows, and residents interested in shoulder surgery,premier approaches to arthroscopic rotator cuff repairexplains the latest techniques in arthroscopic surgery for rotat. Rehabilitation protocol michael angeline, md department of orthopedic surgery prepared by dalton venden, lat phase 1 surgery to 2 weeks after surgery goals. It is not a big operation to repair a torn rotator cuff, but the rehabilitation time can be long depending on the size of the tear and the quality of the tendonsmuscles.
Plymouth rotator cuff repair rehabilitation protocol phase 1. The protocol is both chronologically and criterion based for advancement through four postoperative phases. The intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient that has undergone an arthroscopic assistedminiopen rotator cuff repair. Rotator cuff repair small to medium rehabilitation guideline this rehabilitation program is designed to return the individual to their activities as quickly and safely as possible. Starting the first day after surgery you should remove the sling 34 times per day to perform pendulum exercises and elbowwrist range of motion unless otherwise specified by dr.
Rotator cuff repair protocol boston shoulder institute. For this reason the shoulder is the most mobile joint in the body. Do not perform long lever arm strengthening exercise for the rotator cuff do not perform scaption with ir empty can at any stage of rehabilitation due to impingement and stress on the repair b. Brace abduction bracesling, remove sling only to bathe and to complete exercises. A rotator cuff tear occurs when a hole forms in the tendon. Madison, wi 53718 surgical repair of a rotator cuff tear can be done arthroscopically or with a miniopen procedure. Rotator cuff repair rehabilitation protocol arthroscopic repair. Toc rotator cuff rehabilitation protocol medium tear. Arthroscopic rotator cuff repair postoperative rehab protocol. After surgery you will be taken to the recovery room where you will remain until comfortable. Rehabilitation protocol for rotator cuff repair small to medium sized tears this protocol is intended to guide clinicians and patients through the postoperative course of a rotator cuff repair.
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