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. These include an inflammatory phase, a proliferative or repair phase, and a remodeling phase. This is because the articular surface of the round humeral head is approximately four times greater than that of the. Rehabilitation protocol for rotator cuff repair massachusetts. Histological studies suggest that three phases of rotator cuff healing occur after surgical repair. This may include physical therapy, antiinflammatory medication, rest, and activity modification. Surgery to repair a torn rotator cuff most often involves reattaching the tendon to the humerus. Rotator cuff repair surgery can now be performed arthroscopically and is in most. Multiple factors can impact the repair, including tissue quality, the age and size.
Sports medicine physical therapy rehabilitation protocols. At your first postop visit you will be given a copy of the operative report which will. 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. Are there differences between an arthroscopic and open rotator cuff repair. Cole,md,mba range of motion immobilizer exercises phase i 04 weeks 02 weeks. Specific interventions should be based on the needs of the individual and should consider exam findings and clinical decision making. Rotator cuff repair protocol boston shoulder institute. Rotator cuff repair postoperative rehabilitation protocol. The intent of this protocol is to provide the clinician with a. Rehabilitation guidelines for type i and type ii rotator. Manual laborers will likely be out of work for at least. However, the existing clinical studies of postoperative treatment targeting patients with rotator cuff repair are of moderate to low quality lack of blinding, small sample sizes, lackpoor responsiveness on outcomes, andor with only per protocol analyses 1520, making it difficult to unequivocally conclude what treatment regimen is the best. The sports physical therapy service is an integral part of the sports medicine center and the department of.
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. Rehabilitation guidelines for rotator cuff repair and isolated subscapularis repair 2 uwsportsmedicine. Time frames allow for optimal healing and should be used as criteria for advancement along with a patients functional. Arthroscopic rotator cuff repair postoperative rehab protocol. 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. Denards rehabilitation protocols arthroscopic shoulder surgery. The overarching philosophy of rehabilitation is centered on the principle of the gradual application of controlled stresses to the healing rotator cuff repair with consideration of rotator cuff tear size, tissue quality, and patient variables. Rotator cuff repair protocol south shore orthopedics. For this reason the shoulder is the most mobile joint in the body. It is designed for rehabilitation following large to massive rotator cuff repairs.
No arom exercise of the shoulder consistent use of sling unless otherwise instructed weaning starting at week 4 at earliest. Scapular stabilization exercises sidelying advance to manual resistance. This protocol provides you with general guidelines for the rehabilitation of patients following a massive open andor arthroscopic rotator cuff repair. Rotator cuff repair of protocol page3 phase 1 immediate post operative this phase involves the initial recovery period after surgery and generally lasts until 46 weeks post operative. The authors protocol of choice, used within a large sports medicine rehabilitation center, is presented and the rationale behind its implementation is discussed. Specific changes in the program will be made by the physician as appropriate for an individual patient. Begin active and manual scapula strengthening exercises. The physician will make specific changes to the program as appropriate for an individual patient. If initial nonsurgical treatment of a rotator cuff tear fails, surgical repair is often the next line of treatment. Rotator cuff repair large to massive 5cm rehabilitation. Stone invented one of the first suture anchors designed for rotator cuff repair, the questis suture anchor, and has been involved in technique design. It is not intended to be a substitute for clinical decision. The team at the stone clinic has been repairing rotator cuffs for over twenty years and has progressively improved the techniques.
We provide our patients with comprehensive, coordinated care from experts who understand the unique needs of women in sports. Abduction bracesling, remove sling only to bathe and to. Standard rotator cuff repair protocol this protocol is designed to serve as a patient rehabilitation guide following a standard rotator cuff repair procedure. Arthroscopic rotator cuff repair protocol brigham and womens. Rehabilitation protocol for rotator cuff repair this protocol is intended to guide clinicians and patients through the postoperative course of a rotator cuff repair. The socket portion of the joint is not naturally deep. This protocol provides you with general guidelines for the conservative rehabilitation of the patient with a rotator cuff tear rct. They attach from the shoulder blade onto the top of the arm bone. 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 tendons involved, the quality of tissue and. Subacromial decompression andor distal clavicle excision in most cases, these procedures are performed in conjunction with another surgery and the rehab. 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. Progressive early passive and active exercise therapy. 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. The american society of shoulder and elbow therapists.
Arthroscopic and open rotator cuff repair rehabilitation protocol week 1 2 shoulder sling and swathe full time day and night. Find pdfs of our most common rehabilitation protocols. If you have any questions regarding the progress of the patient, the physician should be. No arom exercise of the shoulder consistent use of sling unless otherwise instructed weaning starting at week 4. 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. Most rotator cuff tears can be repaired surgically by reattaching the torn tendons to the humerus. These muscles help keep the joint in the correct position and control shoulder movements. Department of rehabilitation services physical therapy arthroscopic rotator cuff repair protocol. 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. Sling immobilization with supporting abduction pillow to be worn at all times except for showering and rehab under guidance of pt. The conservative approach may be associated with postoperative stiffness which can be managed once healing has occurred.
Many different factors influence the postoperative rotator cuff repair rehabilitation outcome, including rotator cuff tear size, type of repair, tissue quality, number of. 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. Brace abduction bracesling, remove sling only to bathe and to complete exercises. Rotator cuff repair rehab protocol the stone clinic. Postoperative rotator cuff repair rehabilitation 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.
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