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. Initiate with submax painfree isometrics and arom as outlined in the protocol. 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. Following rotator cuff repair surgery, a postoperative abduction pillow brace supporting the shoulder 30 abduction is used, for a minimum of 26 weeks, as there. Rotator cuff and shoulder rehabilitation exercises. 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. Clinical guidelines for cpm following rotator cuff repair.
Specific interventions should be based on the needs of the individual and should consider exam findings and clinical decision making. It is designed for rehabilitation following large to massive rotator cuff repairs. Postoperative rehabilitation guidelines for arthroscopic rotator cuff repair arthroscopic assisted miniopen rotator cuff repair sling immobilization aettve rom elbow, wrist and hand passive only rom shoulder pendu i, elevation 140 degrees external rotation 40 degrees scapular stabilization exercises sidelying. Rehabilitation recovery from a shoulder surgery takes several months. 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. Romeo, md, and bernard bach, jr, md normal shoulder function requires a balanced relationship between glenohumeral mobility and glenohumeral stability. Rotator cuff repair with biceps releasetenodesis brian bjerke, md postoperative protocol phase i maximum protection week 0 to 6 goals. Sling x 6 weeks ultrasling x 46 weeks, larger tears may be in ultrasling x 6 weeks then. Arthroscopic rotator cuff repair postoperative rehab protocol. Find out how physical therapy exercises and other treatment can help you feel better. The shoulder is a wonderfully complex joint that is made up of the ball and socket connection.
This protocol provides you with general guidelines for the rehabilitation of patients following a massive open andor arthroscopic rotator cuff repair. Rehabilitation guidelines for type i and type ii rotator. Modifications to this guideline may be necessary dependent on physician specific. Postoperative rotator cuff repair rehabilitation protocol. Rotator cuff repair postoperative rehabilitation protocol. Most rotator cuff tears can be repaired surgically by reattaching the torn tendons to the humerus. 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. The rotator cuff complex is comprised of four tendons from four muscles. 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. Brace abduction bracesling, remove sling only to bathe and to complete exercises. 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. Rotator cuff repair postoperative rehabilitation protocol orthoindy.
Department of rehabilitation services physical therapy arthroscopic rotator cuff repair protocol. A large size rotator cuff tear is defined as a tear 35cm. The suturesanchors hold the tendons so they can heal back to the bone. If you have any questions regarding the progress of the patient, the physician should be. Rehabilitation after rotator cuff repair the open orthopaedics journal, 2017, volume 11 159 known as jump training or plyos, which for example include a patient throwing and catching a. Cole,md,mba range of motion immobilizer exercises phase i 04 weeks 02 weeks. We have remained at the forefront of medicine by fostering a culture of collaboration, pushing the boundaries of medical research, educating the brightest medical minds and maintaining an unwavering commitment to the diverse communities we serve. These muscles help keep the joint in the correct position and control shoulder movements.
Full functioning may not return for six months or more. Arthroscopic rotator cuff repair protocol brigham and womens. Throw from pitcher s mound at 9 months collision sports. Madison, wi 53718 surgical repair of a rotator cuff tear can be done arthroscopically or with a miniopen procedure. This included data on small to large tears however massive tears. Rotator cuff repair is the surgery used to repair a tear in one of these tendons. Open surgery is required to repair the rotator cuff tear that is medium to large in size. For this reason the shoulder is the most mobile joint in the body. The socket portion of the joint is not naturally deep. Modifications to this guideline may be necessary dependent on physician. Many different factors influence the postoperative rotator cuff repair rehabilitation outcome, including rotator cuff tear size, type of repair, tissue quality, number of. Repair guideline background the rotator cuff is responsible for stabilization and active movement of the glenohumeral joint. Exercises and physical therapy for rotator cuff tear.
The rotator cuff is an integral part of the anatomy of the shoulder. It is prone to injury, but doing specific exercises can help prevent this. Rotator cuff repair small to medium rehabilitation guideline. The conservative rehabilitation protocol allows sharpey fibers to form before stressing the repair with resistive exercises. General time frames are given for reference to the average, but individual patients will progress at.
Prom as instructed restrictionsexercise progression. The rotator cuff is made up of 4 muscles supraspinatus, infraspinatus, subscapularis, and teres minor that help stabilize the shoulder. The four shoulder muscles that make up the rotator cuff can get worn or tear. Starting the first day after surgery you should remove the sling 34 times per day to perform. 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. Rehabilitation protocol for rotator cuff repair this protocol is intended to guide clinicians and patients through the postoperative course of a rotator cuff repair. Kate hopman2, lee krahe1, sue lukersmith2, alexander mccoll1, kris vine1. Rehabilitation protocol for rotator cuff repair massachusetts. Clinic appointments at 8 to 12 days, then at 6 weeks, 12 weeks, 18 weeks, and possibly 24 weeks physical therapy appointment starting at 9 weeks, lasting 18 to 24 weeks acute phase. Rotator cuff repair protocol south shore orthopedics. Abduction bracesling, remove sling only to bathe and to. They attach from the shoulder blade onto the top of the arm bone.
Talk to your doctor or physical therapist about which exercises will best help you meet your rehabilitation goals. Elbow therapists consensus statement on rehabilitation following arthroscopic rotator cuff repair. Rotator cuff repair large to massive 5cm rehabilitation. Rehabilitation guidelines for rotator cuff repair and isolated subscapularis repair 2 uwsportsmedicine.
Arthroscopic and open rotator cuff repair rehabilitation protocol week 1 2 shoulder sling and swathe full time day and night. Pdf rehabilitation following arthroscopic rotator cuff. It is designed for rehabilitation following small to medium rotator cuff repairs. Specific changes in the program will be made by the physician as appropriate for an individual patient. The intent of this protocol is to provide the clinician with a.
Symptoms of rotator cuff injuries people of all ages injure their rotator cuffs. After a rotator cuff repair surgery, patients are required to wear a sling for four weeks. Rehabilitation of the shoulder after rotatorcuff repair. Clinical practice guidelines for the management of rotator. The conservative approach may be associated with postoperative stiffness which can be managed once healing has occurred. Many of the studies compare different surgical techniques and there is a lack of consistency in postoperative rehabilitation. Synchronized or isolated protocol the primary goal of postsurgical rehabilitation following rotator cuff repair is to control pain, protect repaired tissue during the healing process, restore function, improve rangeofmotion, restore strength and prevent a. 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. No arom exercise of the shoulder consistent use of sling unless otherwise instructed weaning starting at week 4 at earliest.
If initial nonsurgical treatment of a rotator cuff tear fails, surgical repair is often the next line of treatment. Rotator cuff repair and rehabilitation surgical indications and considerations anatomical considerations. No arom exercise of the shoulder consistent use of sling unless otherwise instructed weaning starting at week 4. 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. In rotator cuff repair surgery one or more of these muscles are reattached to the bone using anchorssutures. A study on the rehabilitation protocol after a rotator cuff repair suggested that shoulder joint exercise and shoulder muscle activation should be restricted for at least four to 16 one of the. It is evident that a successful outcome after surgical rotator cuff repair is as much dependent on surgical technique as it is on rehabilitation. To ensure that this program is safe and effective for you, it should be performed under your doctors supervision.
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