No resisted rotator cuff strengthening exercises until weeks patients this protocol should be used as a guide during your rehabilitation after surgery. Rotator cuff and shoulder conditioning program orthoinfo aaos. Remove sling for light activity and home exercise program as indicated by therapist. At a 30 degree angle in front of the body with thumb pointed up, slowly raise arm to shoulder height.
For this reason the shoulder is the most mobile joint in the body. 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. 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. 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. This particular protocol divided into 4 phases and the timeline can vary from 4 months to. Postoperative rotator cuff repair rehabilitation protocol. Your surgeon will advise when you should start physiotherapy at your first followup appointment. Rotator cuff repair protocol boston shoulder institute. Maintenance and continuation of isotonic strengthening exercises should be encouraged 12xweek for 36 months. Conservative rotator cuff tear protocol sports and orthopedic. The rotator cuff is a group of muscles and tendons, which hold the glenohumeral joint together and help lift the arm overhead, such as throwing a ball or swimming. Specific changes in the program will be made by the physician as appropriate for an individual patient.
Rotator cuff repair postoperative rehabilitation protocol. It provides stability and strength for the shoulder joint, anchoring the humerus upper arm bone to the scapula shoulder blade so that movements of the arm can occur in a. Three of the four rotator cuff muscles attach from the back of the shoulder blade to the arm bone. Rehabilitation protocol for total shoulder arthroplasty and hemiarthroplasty this protocol is intended to guide clinicians and patients through the postoperative course after a total shoulder arthroplasty tsa and hemiarthroplasty. Rehabilitation guidelines for type i and type ii rotator.
Most rotator cuff tears can be repaired surgically by reattaching the torn tendons to the humerus. The conservative approach may be associated with postoperative stiffness which can be managed once healing has occurred. Good control of rotator cuff and scapular musculature through functional range through functional range. Department of rehabilitation services physical therapy arthroscopic rotator cuff repair protocol. Do not add, alter, or skip any of the treatments in this protocol. The socket portion of the joint is not naturally deep. The rotator cuff is made up of four muscles supraspinatus, infraspinatus, subscapularis, and teres minor and their tendons. The authors protocol of choice, used within a large sports medicine rehabilitation center, is presented and the rationale behind its implementation is discussed. Large rotator cuff repair protocol the intent of this protocol is to provide the clinician with instruction, direction, rehabilitative guidelines and functional goals for all rotator cuff repair procedures. A large size rotator cuff tear is defined as a tear 35cm, massive 5cm. Rehabilitation protocol for rotator cuff repair this protocol is intended to guide clinicians and patients through the postoperative course of a rotator cuff repair. If biceps tenodesis was performed no biceps strengthening until 8 weeks postop frequency.
Rotator cuff repair postoperative rehabilitation protocol orthoindy. Abduction bracesling, remove sling only to bathe and to. Supraspinatus open can patient stands with theraband under their foot while grasping theraband, bring shoulders back and down. He recommends delaying strengthening until 3 to 4 months postoperatively. No arom exercise of the shoulder consistent use of sling unless otherwise instructed weaning starting at week 4 at earliest. The deltoid muscle is separated to expose the torn rotator cuff tendons. This rehabilitation program has been distilled from seven level 1 or level 2 randomized controlled trials that demonstrate benefits from physical therapy for treating rotator cuff pain. Specific interventions should be based on the needs of the individual and should. Eleven randomized, controlled trials level 1 and 2 evaluating the effect of exercise in the treatment of impingement were identified. Rotator cuff repair page 4 page 5 rotator cuff repair the rotator cuff the rotator cuff is a group of muscles closely wrapped around the shoulder. Rotator cuff postoperative rehabilitation protocol general considerations.
Rehabilitation protocol for rotator cuff repair massachusetts. At your first postop visit you will be given a copy of the operative report which will help the therapist guide your therapy appropriately. The conservative rehabilitation protocol allows sharpey fibers to form before stressing the repair with resistive exercises. Talk to your doctor or physical therapist about which exercises will best help you meet your rehabilitation goals. Cole,md,mba range of motion immobilizer exercises phase i 04 weeks 02 weeks. The speed in which you progress through these phases of rehab may be altered depending upon the size of your tear and the quality of the tissue. This protocol provides you with general guidelines for the rehabilitation of patients following a massive open andor arthroscopic rotator cuff repair. The rotator cuff is a group of four tendons that attach to. Early passive range of motion of the glenohumeral joint to prevent capsular adhesions is essential. The shoulder rehabilitation protocol consists of two major components. If you have any questions regarding the progress of the patient, the physician should be. Rotator cuff repair protocol south shore orthopedics. A physiotherapist should be consulted throughout to teach and individually modify the exercises. To provide an overview of the characteristics and timing of rotator cuff healing and provide an update on treatments used in rehabilitation of rotator cuff repairs.
Rehabilitation guidelines rehabilitation guidelines after arthroscopic rotator cuff repair mark a. Exercise in the treatment of rotator cuff impingement. Rotator cuff repair rehab protocol the stone clinic. Rehabilitation guidelines for type i and type ii rotator cuff repair and isolated subscapularis repair the anatomic configuration of the shoulder joint glenohumeral joint is often compared to that of a golf ball on a tee. The physician will make specific changes to the program as appropriate for an individual patient. A small size rotator cuff tear is defined as a tear rehabilitation protocol for rotator cuff repair this protocol is intended to guide clinicians and patients through the postoperative course of a rotator cuff repair. Rehabilitation after rotator cuff repair the open orthopaedics journal, 2017, volume 11 157 about the surgery, such as the size of the tear, the exact. This protocol provides you with general guidelines for the conservative rehabilitation of the patient with a rotator cuff tear rct. This is because the articular surface of the round humeral head is approximately four times greater than that of the. Bedi et al2 reported a recurrence rate of up to 94%. It is not intended to be a substitute for clinical decision. Brace abduction bracesling, remove sling only to bathe and to complete exercises.
Arthroscopic and open rotator cuff repair rehabilitation protocol week 1 2 shoulder sling and swathe full time day and night. Rehabilitation protocol for total shoulder arthroplasty. Rehabilitation protocol for small to moderate rotator cuff tear. Many different factors influence the postoperative rotator cuff repair rehabilitation outcome, including rotator cuff tear size, type of repair, tissue quality, number of. External rotation at 90 degrees, internal rotation at 90 degrees resistance band. The intent of this protocol is to provide the clinician with a. The rotator cuff is responsible for stabilization and active movement of the glenohumeral joint. Specific interventions should be based on the needs of the individual and should consider exam findings and clinical decision making. 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. Summary table post op phasegoals range of motion therapeutic exercise precautions days 1 7 wear sling during the day and at night remove sling for showeringbathing remove sling 4 to 5 times per day for gentle elbow, forearm, wrist and finger exercises.
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