The sports physical therapy service is an integral part of the sports medicine center and the department of. Pdf rehabilitation after rotator cuff repair researchgate. Jazrawi, md associateprofessoroforthopaedics chief2divisionofsportsmedicine tel. No arom exercise of the shoulder consistent use of sling unless otherwise instructed weaning starting at week 4. Marsh brook rehabilitation service wentworthdouglass hospital durham. This may include physical therapy, antiinflammatory medication, rest, and activity modification. After an injury or surgery, an exercise conditioning. The physician will make specific changes to the program as appropriate for an individual patient. We provide our patients with comprehensive, coordinated care from experts who understand the unique needs of women in sports. After an injury or surgery, an exercise conditioning program. Will i progress just like my friend who had rotator cuff repair surgery. 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.
Initiating rotator cuff and scapula stabilization strengthening exercises should be. 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. Rotator cuff and shoulder conditioning program orthoinfo aaos. This protocol provides you with general guidelines for the conservative rehabilitation of the patient with a rotator cuff tear rct. Rehabilitation guidelines for type i and type ii rotator. The authors protocol of choice, used within a large sports medicine rehabilitation center, is presented and the rationale behind its. Rotator cuff repair protocol south shore orthopedics. Rehabilitation guidelines for rotator cuff repair and isolated subscapularis repair 2 uwsportsmedicine. 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. Rehabilitation of the shoulder following rotator cuff. The conservative approach may be associated with postoperative stiffness which can be managed once healing has occurred. 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. Many different factors influence the postoperative rotator cuff repair rehabilitation outcome, including rotator cuff tear size, type of repair, tissue quality, number. Clinical practice guidelines for the management of rotator cuff syndrome in the workplace the university of new south wales, medicine, rural clinical school, port macquarie campus 20 research team.
Rehabilitation protocol for rotator cuff repair massachusetts. Department of rehabilitation services physical therapy arthroscopic rotator cuff repair protocol. Greatest likelihood of reinjury is during bathing, dressing, toileting, and sleep. Evaluation of rotator cuff injury, shoulder instability, or impingement via exam. A torn rotator cuff due to an injury is usually best treated by immediate surgical repair. The conservative rehabilitation protocol allows sharpey fibers to form before stressing the repair with resistive exercises. To ensure that this program is safe and effective for you, it should be performed under your doctors supervision. Kate hopman2, lee krahe1, sue lukersmith2, alexander mccoll1, kris vine1. A small size rotator cuff tear is defined as a tear. Abduction bracesling, remove sling only to bathe and to complete exercises. Our classification of these injuries and treatment protocol is based on knowledge of the pathophysiology of events leading to rotator cuff failure.
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. If the treating physical therapist needs to learn more about biceps. Rotator cuff repair most rotator cuff tears can be repaired surgically by reattaching the torn tendons to the humerus. This rotator cuff strain rehabilitation program is based around four stages. The path to regaining range of motion, strength and function can require a sustained and coordinated effort from the patient, his or her family, the ohio state sports medicine physical therapy team and sometimes, other healthcare providers. After an injury or surgery, an exercise conditioning program will help you return to daily activities and enjoy a more active, healthy lifestyle. Rotator cuff patient info massachusetts general hospital. Pdf background rotator cuff tears are a very common condition that is often. Talk to your doctor or physical therapist about which exercises will best help you meet your rehabilitation goals. The socket portion of the joint is not naturally deep. Nonoperative rotator cuff tear protocol acuteearly phase limited, painful arom, painful resisted testing subacutemid phase. Rotator cuff and shoulder rehabilitation exercises. Rehabilitation of rotator cuff injuries consists of four elements. Pendulum exercises to begin 21 days after surgery, no pendulums before this time.
Sports medicine physical therapy rehabilitation protocols. Rotator cuff repair protocol boston shoulder institute. Begin active and manual scapula strengthening exercises. Manual laborers will likely be out of work for at least. Postoperative protocol this rehabilitation protocol has been developed for the patient following a rotator cuff surgical procedure. 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 postoperative rehabilitation protocol orthoindy. Clinical practice guidelines for the management of rotator. Postoperative rotator cuff repair rehabilitation protocol. Background description o commonly occurs in patients between the ages of 4070. This is because the articular surface of the round humeral head is approximately four times greater than that of the. These guidelines are presented in reference to tendonrelated procedures, but general guidelines. Following the acute injury you should use a knee immobilizer and crutches until you regain good muscular control of the leg. Specific interventions should be based on the needs of the individual and should consider exam findings and clinical decision making.
Rehabilitation protocol for rotator cuff repair this protocol is intended to guide clinicians and patients through the postoperative course of a rotator cuff repair. Rotator cuff repair rehab protocol the stone clinic. If you have questions or concerns regarding your surgery or the rehabilitation protocol and exercises call 6177267500. 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.
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. A physiotherapist should be consulted throughout to teach and individually modify the exercises. Prolonged exercise rehabilitation and nonoperative treatment should be considered in patients with rotator cuff tendinopathies, partialthickness tears, and potentially small fullthickness tears, due to the limited risk for irreversible, chronic rotator cuff changes. Early passive range of motion of the glenohumeral joint to prevent capsular adhesions is essential. Rotator cuff injury and treatment options the rotator cuff can tear as an acute injury such as when lifting a heavy weight or falling on the shoulder or elbow. It is not intended to be a substitute for clinical decision. Brace abduction bracesling, remove sling only to bathe and to complete exercises. A gentle rehabilitation protocol with limits in range of motion and exercise times. Rehabilitation of the shoulder following rotator cuff injury or surgery clive brewster, ms, rpt diane r. Ohio state physicians and physical therapists work collaboratively to develop best clinical practices for postsurgical rehabilitation. Rotator cuff repair surgery can now be performed arthroscopically and is in most. Rotator cuff and shoulder rehabilitation exercises orthoinfo aaos.
No resisted rotator cuff strengthening exercises until weeks patients this protocol should be used as a guide during your rehabilitation after surgery. The shoulder is immediately weak and there is pain when trying to lift the arm. Arthroscopic rotator cuff repair protocol brigham and womens. Classification and treatment of rotator cuff injuries in. Rotator cuff tendonitisimpingement rehabilitation protocol.
Your surgeon will advise when you should start physiotherapy at your first followup appointment. Elbow and wrist active motion arom with shoulder in neutral position at side. This protocol will vary in length and aggressiveness depending on factors such as. Find pdfs of our most common rehabilitation protocols. Rotator cuff repair postoperative rehabilitation protocol. Manual technique to address posterior capsular hypomobility use conservatively. Remove sling for light activity and home exercise program as indicated by therapist. Rehabilitation protocol for small to moderate rotator cuff tear. Rehabilitation protocols ohio state sports medicine. Rotator cuff injury in athletes results from accumulation of microtrauma to both the static and dynamic stabilizers of the shoulder.
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. Rotator cuff sprain and strains university of california. The rotator cuff is made up of four muscles supraspinatus, infraspinatus, subscapularis, and teres minor and their tendons. No arom exercise of the shoulder consistent use of sling unless otherwise instructed weaning starting at week 4 at earliest. Moynes schwab, ms, rpt2 r otator cuff injuries oc cur because of mechan ical abrasion within a decreased glenohu meral joint space. The acute stage, immediately after injury, recovery stage, functional stage and returning to full fitness.
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