Most rotator cuff tears can be repaired surgically by reattaching the torn tendons to the humerus. Pdf rotator cuff disease of the shoulder, a common condition, is often. It is no means intended to be a substitute for ones. Rotator cuff repair protocol is a rehabilitation protocol to provide patient with the guidelines following a rotator cuff surgical procedure. Physical therapy arthroscopic rotator cuff repair protocol. The rotator cuff is responsible for stabilization and active movement of the glenohumeral joint. Rehabilitation protocol for rotator cuff repair this protocol is intended to guide clinicians and patients through the postoperative course of a rotator cuff repair. Pdf background rotator cuff tears are a very common condition that is often. The rotator cuff can tear as an acute injury such as when lifting a heavy weight or falling on the shoulder or elbow.
Type three rotator cuff repair miniopen or neer approach large to massive tear greater than 5 cm i. The first classification is a partial thickness or. Strengthen deltoid, rotator cuff and scapular stabilizers. Rehabilitation of the shoulder after rotatorcuff repair. Arthroscopic and open rotator cuff repair rehabilitation protocol week 1 2 shoulder sling and swathe full time day and night. Stay in sling except for exercises therapeutic exercise. Rotator cuff repair rehabilitation protocol protocol for subscapularis repair rehabilitation prepared by dr boyle.
This may be performed arthroscopically or through open surgery, using sutures and bone anchors. This protocol is intended to guide clinicians and patients through the post operative course of a rotator cuff repair. Exercise in the treatment of rotator cuff impingement. Pdf rehabilitation after arthroscopic rotator cuff. Please dont hesitate to contact amy baer pt, atc or geoff omiatek pt, at, ms, scs at 614 8271050 with any. For this reason the shoulder is the most mobile joint in the body. This evidencebased small to medium rotator cuff repair physical therapy guideline is. However, a comprehensive approach aimed at identifying all possible. The shoulder is immediately weak and there is pain when trying to lift the arm. Rehabilitation guidelines for smallmedium rotator cuff tears following surgical repair phase i. Exercise protocol for the treatment of rotator cuff. What is the role of exercise in the treatment of rotator cuff. Phase i immediate postoperative phase weeks 0 6 days 014 patient is seen 2 days postoperative to remove surgical dressings and pain catheter.
The intent of this protocol is to provide guidelines for your patients therapy progression. Protocol s3 accelerated physical therapy protocol for. Rotator cuff repair protocol small orthopaedicsone. Rolf 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 labral repair.
Appropriate healing of the repair by adherence to precautions, immobilization guideline and exercise protocol. Physical therapy and rehabilitation after rotator cuff repair. Tearing of the rotator cuff tendons insertion on the humerus. Rotator cuff repair rehabilitation protocol the following document is an evidencebased protocol for arthroscopic rotator cuff repair rehabilitation. Specific interventions should be based on the needs of the individual and should consider exam findings and clinical decision making. Arthroscopic labral repair protocoltype ii, iv, and complex tears. The protocol is both chronologically and criterion based for advancement through four postoperative phases. 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. Immediate postop phase first 57 days after surgery, prior to starting pt goals. This evidencebased large to massive rotator cuff repair physical therapy guideline is. Associate professor department of orthopaedic surgery.
No arom exercise of the shoulder consistent use of sling unless otherwise instructed weaning starting at week 4 at earliest pendulum exercises, elbow aarom and gripping 4x per day starting pod 3. Phase 1 initial 6 week postsurgery patient is immobilized for six weeks. The intent of this protocol is to provide the clinician with a. Patients over 50 years of age are more susceptible to sustaining a significant rotator cuff tear from trauma. Type one rotator cuff repair arthroscopic or miniopen small tear less than 1 cm i. Rotator cuff rc disease is a frequent cause of shoulder pain and can result in weakness, alterations in glenohumeral kinematics, and shoulder instability in some circumstances. Rotator cuff repair protocol south shore orthopedics. Rotator cuff tendonitis bursitis rehabilitation protocol. Rotator cuff tears can be classified in various ways. Early passive range of motion of the glenohumeral joint to prevent capsular adhesions is essential. This protocol is intended to guide clinicians and patients through the postoperative course of a rotator cuff repair. Contact dr kevin murphy at 9046340640 to know more.
Shoulder strengthening exercises for rotator cuff phase ii shoulder strengthening exercises for rotator cuff phase ii the following is your personalized exercise program prescribed by your physical therapist. My procedures are generally an arthroscopic evaluation, subacromial bursectomy, or an acromioplasty with miniopen rotator cuff repair. This protocol provides you with general guidelines for the rehabilitation of patients following a massive open andor arthroscopic rotator cuff repair. Pendulums table slides into flexion, external rotation, and abduction in scapular p. Continue with end range stretching and manual therapy as. This process alone can lead to rotator cuff tears in older patients. If you have any questions regarding the progress of the patient, the physician should be. Rehabilitation after arthroscopic rotator cuff repair.
Multiple nonoperative rehabilitation protocols have been described for the treatment of the spectrum of rotator cuff injury. The rotator cuff also acts as dynamic ligaments when their passive elements are put on stretch. The deltoid muscle is separated to expose the torn rotator cuff tendons. Rotator cuff repair protocol rotator cuff protocol. Rotator cuff tendonitisimpingement rehabilitation protocol. The deltoid is divided in line with the portal site with a small incision.
Rotator cuff repair protocol this rehabilitation protocol has been developed for the patient following a rotator cuff surgical procedure. Shoulder rotator cuff repair operative rehabilitative protocol. The socket portion of the joint is not naturally deep. This protocol will vary in length and aggressiveness depending on factors such as. Boyle cryotherapy as needed for pain relief cryocuff or ice pack no pendulum. An evaluationbased approach abstract rotator cuff disease of the shoulder, a common condition, is often incapacitating. Define the protocol to be followed for all patients referred from northwestern. Begins immediately after surgery to approximately 4 weeks postop. Rotator cuff repair rehabilitation protocol matthew. Size and location of tear degree of shoulder instabilitylaxity prior to surgery acute versus chronic condition. Whether nonsurgical or surgical, successful management of rotator cuff disease is dependent on appropriate. The procedure involves stitching the torn tendon back onto its attachment to the humerus. Rotator cuff bursitis tendonitis rehabilitation protocol. A comprehensive approach to nonoperative rotator cuff.
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 protocol for rotator cuff repair massachusetts. Numerous rehabilitation protocols for the management of rotator cuff disease are. Rotator cuff repair protocol boston shoulder institute. Rotator cuff repair postoperative rehabilitation protocol. Arthroscopic labral repair protocoltype ii, iv, and. Rehabilitation protocol after arthroscopic rotator cuff. Specific changes in the program will be made by the physician as appropriate for an individual patient.
Numerous rehabilitation protocols for the management of rotator cuff. These muscles merge into tendons and this muscle structure allows the arm to be lifted and rotated. Rotator cuff rehabilitation protocol scott orthopedic center. One of the primary conditions targeted in rehabilitation of the shoulder is rotator cuff injury. Quality of tissue and integrity of repair2 stronger tissue if tendonitisimpingement rehabilitation protocol. The rotator cuff is then repaired directly to the bone with a. Shoulder rotator cuff repair operative rehabilitative protocol the physical therapy rehabilitation for rotator cuff repair will vary in length depending on the degree of instability, acute verses chronic conditions, strengthrom status and activity demands. Most protocols are implemented under the pretense of treating areas local to the site of symptoms. Rotator cuff postoperative rehabilitation protocol general considerations. Rehabilitation guidelines for type i and type ii rotator. Protocols can vary as drastically as beginning gentle passive range of motion and isometric exercises postoperative week 1 to delaying 12 weeks for the initiation of similar exercises.
A large size rotator cuff tear is defined as a tear 35cm, massive 5cm. This rehabilitation protocol has been developed for the patient following a shoulder arthroplasty replacement procedure. And more confusing is the lack of consensus among surgeons regarding the optimal postoperative rehabilitation protocol following arthroscopic rotator cuff repair. Postoperative rotator cuff repair rehabilitation protocol. Aaromarom short arc motions in newly acquired range of. Clinic appointments at 8 to 12 days, then at 6 weeks, 12 weeks, 18 weeks and possibly 24 weeks postop physical therapy appointment starting at 2 weeks, lasting 12 to 18 weeks acute phase. Rotator cuff repair protocol small day 1 postop change dressings.
Shawn hennigan, md rotator cuff repair rehabilitation protocol. Rehabilitation protocol after arthroscopic rotator cuff repair. Rotation medical patch rehabilitation protocol phase i. Numerous rehabilitation protocols for the management of rotator cuff disease. 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. The term rotator cuff describes four muscletendon units that connect the upper bone of the arm to the shoulder blade. The intent of this protocol is to provide the therapist and patient with guidelines for the postoperative rehabilitation course after arthroscopic rotator cuff repair. Pictures courtesy of simpleset, used with permission. Protocol s3 accelerated physical therapy protocol for rotator cuff repair arthroscopic or miniopen technique recommended for mild. Rotator cuff repair guidelines our physicians at orthopedic one are committed to working with any licensed rehabilitation provider to assist with their patients postoperative care. Protocol for smallmed rotator cuff andreas sauerbrey, m. Domb would like to personally thank you in advance for taking care of our mutual patient postoperatively. Combining our own published results and experience with the best evidence based research available, this program allows patients to resume regular activities by.
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