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