Rotator cuff repair is the surgery used to repair a tear in one of these tendons. Regain normal strength and painfree function of the shoulder. The criteria to progress from phase i to phase ii is a pain free passive motion. A total of 27 patients who underwent rotator cuff repair were randomized to a rehabilitation group that used pulleys initiated 6 weeks postoperatively, and 26 patients followed a rehabilitation protocol without pulleys. 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. Arthroscopic rotator cuff repair protocol medium to large tear size this protocol was developed to provide the rehabilitation professional with a guideline of postoperative rehabilitation course for a patient who has undergone an arthroscopic medium to large size rotator cuff tear repair. Arthroscopic and open rotator cuff repair rehabilitation protocol week 1 2 shoulder sling and swathe full time day and night. How ever, the most frequent cause in an active young adult is excessive ante. The effects of a standard postoperative rehabilitation. The four shoulder muscles that make up the rotator cuff can get worn or tear. Exercises and physical therapy for rotator cuff tear. Unfortunately, there is no consensus on the rehabilitation protocols and contents following the surgical procedure. This is because the articular surface of the round humeral head is approximately four times greater than that of the.
Whether nonsurgical or surgical, successful management of rotator cuff disease is dependent on appropriate rehabilitation. Tears of the rotator cuff tendons rc are a frequent cause of shoulder complaints. Pdf rehabilitation after rotator cuff repair researchgate. Rehabilitation protocol for rotator cuff repair massachusetts. Those patients who have good rotator cuff tissue integrity, a one to two tendon repair, with a tear 3 centimeters or less will typically be progressed on the quicker end of these time frames. It is designed for rehabilitation following large to massive rotator cuff repairs.
Rotator cuff repair rehabilitation guide matthew boes, md. The authors protocol of choice, used within a large sports medicine rehabilitation center, is presented and the rationale behind its implementation is discussed. Moynes schwab, ms, rpt2 r otator cuff injuries oc cur because of mechan ical abrasion within a decreased glenohu meral joint space. A small size rotator cuff tear is defined as a tear rotator cuff repair is performed, either arthroscopically or via miniopen procedure, by suturing the torn tendon to the. 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. The socket portion of the joint is not naturally deep. Conservative treatment of rotator cuff injuries to avoid surgical repair by jill schuldt, lmt through a systematic investigation, the rotator cuff was studied to evaluate and define its associated injuries and how conservative treatment of these injuries leads to corrective resolution, eliminating the need for surgical repair. Are pulley exercises initiated 6 weeks after rotator cuff. Arthroscopic rotator cuff repair protocol medium to large.
For this reason the shoulder is the most mobile joint in the body. These exercises are intended for the initial strengthening of acute shoulder problems, andor longterm rehabilitation for massive rotator cuff tears and other conditions resulting in longterm severe weakness. Nov 08, 2016 recovery phase rotator cuff strain rehabilitation. Arthroscopic rotator cuff repair rehabilitation protocol. Symptoms of rotator cuff injuries people of all ages injure their rotator cuffs. Evidence from two or more high quality studies with consistent findings for recommending. If initial nonsurgical treatment of a rotator cuff tear fails, surgical repair is often the next line of treatment. Many different factors influence the postoperative rotator cuff repair rehabilitation outcome, including rotator cuff tear size, type of repair, tissue quality, number of. Optimal recovery is facilitated by the use of postoperative protocols that enhance communication. 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. Introduction proper rehabilitation after rotator cuff repair is essential for success, and progresses in stages. Rotator cuff repair large to massive 5cm rehabilitation. Rotator cuff repair protocol south shore orthopedics. Rotator cuff and shoulder conditioning program orthoinfo aaos.
This protocol is designed for the patient following arthroscopic rotator cuff repair. The team at the stone clinic has been repairing rotator cuffs for over twenty years and has progressively improved the techniques. The goals of rehabilitation are to eliminate pain, restore strength, flexibility, and function, and maintain the integrity of the repair. 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. Stone invented one of the first suture anchors designed for rotator cuff repair, the questis suture anchor, and has been involved in technique design, modifications, and improvements ever since. Large rotator cuff repair protocol fowler kennedy sport.
The prevalence of full thickness tears in the general population is about 20% and markedly increased after the age of 50. Brace abduction bracesling, remove sling only to bathe and to complete exercises. Rotator cuff and shoulder rehabilitation exercises. On the other hand, 25% of all individuals over the age of 60 have a rotator cuff tear.
Rehabilitation of the shoulder following rotator cuff injury. 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. Use a weight that makes the last few repetitions difficult, but painfree. Arthroscopic rotator cuff repair small tear rehab protocol craig l. 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 principles of crosseducation can be used early in the rehabilitation phase. Pictures courtesy of simpleset, used with permission.
Rehabilitation, arthroscopic rotator cuff repair, shoulder, scientific. The glsm rotator cuff repair rehabilitation program is an evidencebased and soft tissue healing dependent program. Those patients with poor rotator cuff tissue integrity, tear of 2. Immobilized at all times day and night off for hygiene and.
The recovery phase begins when the initial pain and inflammation have gone and most normal daily activities are pain free and the injured arm has at least 75% range of movement compared to the uninjured one. Full thickness rotator cuff tears are rarely seen in those younger than 40 years of age. All of the exercises should be performed with slow and controlled motion. Rotator cuff tears do not heal, or repair themselves. The american society of shoulder and elbow therapists. Progressive painfree range of motion prom aarom arom. Conventional rehabilitation protocols after reconstruction. After an injury or surgery, an exercise conditioning program will help you return to. Oct 31, 2018 conclusion the present study confirmed an excellent outcome at 1 year after rotator cuff repair using a traditional 4week immobilization followed by a 2week rehabilitation protocol without evidence of tendon unhealing or retearing.
Department of rehabilitation services physical therapy arthroscopic rotator cuff repair protocol. 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. Find out how physical therapy exercises and other treatment can help you feel better. It is designed for rehabilitation following small to medium rotator cuff repairs. Rotator cuff and shoulder rehabilitation exercises to ensure that this program is safe and effective for you, it should be performed under your doctors supervision. The conservative approach may be associated with postoperative stiffness which can be managed once healing has occurred. In fact, some rotator cuff tears will increase in size if. In rotator cuff repair surgery one or more of these muscles are reattached to the bone using. 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. Rotator cuff repair small to medium rehabilitation guideline. This evidencebased small to medium rotator cuff repair physical therapy. 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. Rehabilitation introduction rotator cuff pathology is a common cause of shoulder pain, weakness, limitations to daily activity, and time off from work 1,2.
Clv pt arthroscopic rotator cuff repair small rehab protocol. Open surgery is required to repair the rotator cuff tear that is medium to large in size. Rotator cuff repair protocol boston shoulder institute. Rotator cuff repair post operative rehabilitation protocol. Shawn hennigan, md rotator cuff repair rehabilitation protocol. Quality of tissue and integrity of repair2 stronger tissue if rehabilitation for the patient with good or adequate tissue would be a. Rehabilitation following rotator cuff repair introduction rehabilitation following cuff repair rehab plan rotator cuff repairs in overhead throwers conway. Orthop no am 01 14 baseball players pitchers intratendinous repair average follow up 16 mos 89 89% followed for 1 yr or more returned to preinjury level. Arthroscopic rotator cuff repair frequently asked questions. Phase 1 maximum protection phase 2 active range of motion. Generally speaking, the anchors and suture used to repair your cuff are very strong and rarely fail, but the tissue itself can tear free from the sutures. Rotator cuff repair and rehabilitation surgical indications and considerations anatomical considerations.
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. Initiate with submax painfree isometrics and arom as outlined in the protocol. Rehabilitation of the shoulder following rotator cuff injury or surgery clive brewster, ms, rpt diane r. Inclusion criteria were patients undergoing 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. Move the arm by rocking the body forwardback, side to side, or in a circle. Talk to your doctor or physical therapist about which exercises will best help you meet your rehabilitation goals. Victoria bc v8z 0b9 tel 250 940 4444 fax 250 385 9600 page 1 june 2017 v1s. An evaluationbased approach abstract rotator cuff disease of the shoulder, a common condition, is often incapacitating. Rehabilitation of the shoulder following rotator cuff. A large size rotator cuff tear is defined as a tear 35cm. Conservative rotator cuff tear protocol sports and ortho.
When appropriate, sub maximal and painfree multiangle isometrics for er and ir should be performed to prevent muscular atrophy and to minimize rotator cuff. Postoperative rotator cuff repair rehabilitation protocol. 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. Repair guideline background the rotator cuff is responsible for stabilization and active movement of the glenohumeral joint. 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. Welcome to our rotator cuff repair rehabilitation video series.
Specific interventions should be based on the needs of the individual and should consider exam findings and clinical decision making. General time frames are given for reference to the average, but individual patients will progress at. Use a weight that makes the last few repetitions difficult, but pain free. The protocol is both chronologically and criterion based for advancement through four postoperative phases. Rotator cuff repair most rotator cuff tears can be repaired surgically by reattaching the torn tendons to the humerus. 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. Rehabilitation guidelines for type i and type ii rotator cuff. Gently stretching after strengthening exercises can help reduce muscle soreness and. Isometrics targeting the rotator cuff of the unoperated arm e. Rehabilitation recovery from a shoulder surgery takes several months.
No resisted rotator cuff strengthening exercises until weeks. Rehabilitation guidelines for rotator cuff repair and isolated subscapularis repair 2 uwsportsmedicine. Level of evidence this is a level iv, therapeutic case series. Pdf background rotator cuff tears are a very common condition that is often. The rotator cuff complex is comprised of four tendons from four muscles. Rotator cuff repair postoperative rehabilitation protocol. After a rotator cuff repair surgery, patients are required to wear a sling for four weeks.
Madison, wi 53718 surgical repair of a rotator cuff tear can be done arthroscopically or with a miniopen procedure. How ever, the most frequent cause in an active young adult is. Following arthroscopic rotator cuff repair huberty2009 arthroscopy 489arthroscopic rotator cuff repairs 24 patients 4. Rotator cuff repair rehabilitation program largemassive 5cm. Cole,md,mba range of motion immobilizer exercises phase i 04 weeks 02 weeks. Full functioning may not return for six months or more. The conservative rehabilitation protocol allows sharpey fibers to form before stressing the repair with resistive exercises. Rehabilitation guidelines rehabilitation guidelines after rotator cuff repair mark a. Rehabilitation guidelines for type i and type ii rotator. Rotator cuff repair rehabilitation protocol the following document is an evidencebased protocol for arthroscopic rotator cuff repair rehabilitation. Conservative treatment of rotator cuff injuries to avoid. Rehabilitation following surgical rotator cuff repair may enable return to preinjury function.
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