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. It is not intended to be a substitute for clinical decision. Rotator cuff repair postoperative rehabilitation protocol. Physical therapy standards of care and protocol the following standards of care and protocols are the property of bwh and should not be copied or otherwise used without the permission of the director of rehabilitation services. After an injury or surgery, an exercise conditioning. Rehabilitation guidelines for type i and type ii rotator. Arthroscopic and open rotator cuff repair rehabilitation protocol week 1 2 shoulder sling and swathe full time day and night.
It is not intended to be a substitute for clinical decision making regarding the progression of a patients postoperative course based. Specific interventions should be based on the needs of the individual and should consider exam findings and clinical decision making. Rotator cuff and shoulder rehabilitation exercises orthoinfo aaos. Talk to your doctor or physical therapist about which exercises will best help you meet your rehabilitation goals. Rehabilitation guidelines for type i and type ii rotator cuff. 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.
Sports medicine physical therapy rehabilitation protocols. Verma or either physician assistant supersede the instructions below and should be followed. 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. Clv pt arthroscopic rotator cuff repair small rehab protocol. No resisted rotator cuff strengthening exercises until weeks patients this protocol should be used as a guide during your rehabilitation after surgery. Starting the first day after surgery you should remove the sling 34 times per day to perform pendulum exercises and elbowwrist range of motion unless otherwise specified by dr. Postoperative rotator cuff repair rehabilitation protocol. Purpose of the abductor pillow is to keep tension off of the repair, avoid adduction. Avoid provocative maneuvers or exercises that cause discomfort o includes both offending rom exercises and strengthening exercises. Sling x 6 weeks ultrasling x 46 weeks, larger tears may be in ultrasling x 6 weeks then. Rotator cuff tendonitis rehabilitation protocol impingement is a chronic inflammatory process produced as the rotator cuff muscles supraspinatus, infraspinatus, teres major, and subscapularis and the subdeltoid bursa are pinched against the coracoacromial ligament and the anterior acromion when the arm is raised above 90 degrees.
Rotator cuff repair the following is a protocol for postoperative patients following rotator cuff repair. Arthroscopic rotator cuff repair small tear rehab protocol craig l. Abduction bracesling, remove sling only to bathe and to complete exercises. 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. 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. 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 and shoulder rehabilitation exercises. Shawn hennigan, md rotator cuff repair rehabilitation protocol the following document is an evidencebased protocol for arthroscopic rotator cuff repair rehabilitation. At a 30 degree angle in front of the body with thumb pointed up, slowly raise arm to shoulder height. Sad subacromial decompression protocol phase i postop until week 2 protective phase. The physician will make specific changes to the program as appropriate for an individual patient. Cole,md,mba range of motion immobilizer exercises phase i 04 weeks 02 weeks. 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. The conservative rehabilitation protocol allows sharpey fibers to form before stressing the repair with resistive exercises.
Rotator cuff injury protocols university of california. All of the exercises should be performed with slow and controlled motion. This handout serves as a guideline for your rehabilitation after rotator cuff repair. Rotator cuff repair rehab protocol in the early 1990s, dr. Rotator cuff sprain and strains university of california. Robertsons office and begin a rehabilitation program. This is because the articular surface of the round humeral head is approximately four times greater than that of the. 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. To ensure that this program is safe and effective for you, it should be performed under your doctors supervision. 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. Rotator cuff repair small to medium rehabilitation guideline. Three of the four rotator cuff muscles attach from the back of the shoulder blade to the arm bone. Your surgeon will advise when you should start physiotherapy at your first followup appointment. Department of rehabilitation services physical therapy arthroscopic rotator cuff repair protocol.
Treatment should be modified based on the condition of the rotator cuff. Prom as instructed restrictionsexercise progression. The shoulder is a wonderfully complex joint that is made up of the ball and socket connection. Rotator cuff repair with biceps releasetenodesis brian bjerke, md postoperative protocol phase i maximum protection week 0 to 6 goals. Tear size largemassive tear or 1 tendon repair difficult to achieve full rom, caution with arom and resisted exercises with chroniclarge tears. One high standard, three local partners for more information go to.
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. The intent of this protocol is to provide the clinician with a. Johns hopkins shoulder surgery arthroscopic acromioplasty rehabilitation program johns hopkins shoulder surgeons introduction. Rotator cuff repair postoperative rehabilitation protocol orthoindy. Strengthening of the rotator cuff is done within limits of pain. The rotator cuff is responsible for stabilization and active movement of the glenohumeral joint. Postoperative rehabilitation guidelines for rotator cuff tears please note that these instructions are general guidelines to be followed.
A large size rotator cuff tear is defined as a tear 35cm, massive 5cm. This protocol is designed for the patient following arthroscopic rotator cuff repair. Immediate postop phase first 57 days after surgery, prior to starting pt goals. The socket portion of the joint is not naturally deep. For this reason the shoulder is the most mobile joint in the body.
This protocol is intended to guide clinicians and patients through the post operative course of a rotator cuff repair. No arom exercise of the shoulder consistent use of sling unless otherwise instructed weaning starting at week 4 at earliest. Do not have the patient perform fullcan or emptycan supraspinatus exercises. Rehabilitation protocol for rotator cuff repair this protocol is intended to guide clinicians and patients through the postoperative course of a rotator cuff repair. Remove sling for light activity and home exercise program as indicated by therapist. Keep the abductor pillow in for the 4 weeks as well. 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 primary goal of this protocol is to protect the repair while steadily progressing towards and ultimately achieving preinjury level of activity. 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.
This protocol is intended to guide clinicians and patients through the postoperative course of a rotator cuff repair. Arthroscopic rotator cuff repair frequently asked questions. Those patients with poor rotator cuff tissue integrity, tear of 2. Rotator cuff repair rehab protocol the stone clinic. The team at the stone clinic has been repairing rotator cuffs for over twenty years and has progressively improved the techniques. Reduce pain and inflammation maximize romflexibility of glenohumeral and scapulothoracic joints maximize strengthendurance of rotator cuff and scapular musculature educate client in short term use of sling for protection and activerest if necessary. 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.
The therapist can provide instruction on patient directed active range of motion, patient directed flexibility, and patient directed. The authors protocol of choice, used within a large sports medicine rehabilitation center. The conservative approach may be associated with postoperative stiffness which can be managed once healing has occurred. The intent of this protocol is to provide the therapist and patient with guidelines for the postoperative rehabilitation course after arthroscopic rotator cuff repair.
Brace abduction bracesling, remove sling only to bathe and to complete exercises. Supraspinatus open can patient stands with theraband under their foot while grasping theraband, bring shoulders back and down. This is summary of the evaluation and rehabilitation of a patient following an arthroscopic acromioplasty. Rotator cuff repair protocol south shore orthopedics. Rotator cuff repair protocol boston shoulder institute. Rehabilitation protocol for small to moderate rotator cuff tear. Rehabilitation protocol for rotator cuff repair massachusetts.
Rotator cuff and shoulder conditioning program orthoinfo aaos. Rotation medical patch rehabilitation protocol phase i. This protocol provides you with general guidelines for the conservative rehabilitation of the patient with a rotator cuff tear rct. Specific interventions should be based on the needs of the individual and should. The rotator cuff is made up of four muscles supraspinatus, infraspinatus, subscapularis, and teres minor and their tendons. 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. 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. Most rotator cuff tears can be repaired surgically by reattaching the torn tendons to the humerus.
Shawn hennigan, md rotator cuff repair rehabilitation. Move the arm by rocking the body forwardback, side to side, or in a circle. Arthroscopic rotator cuff repair postoperative rehab protocol. 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. Postoperative rehabilitation guidelines for rotator cuff tears. A physiotherapist should be consulted throughout to teach and individually modify the exercises. It is no means intended to be a substitute for ones. The shoulder rehabilitation protocol consists of two major components. The protocol is both chronologically and criterion based for advancement through four postoperative phases. The shoulder joint is a ball and socket joint that connects. It is essential that he or she follow this rehabilitation program very closely. Conservative rotator cuff tear protocol sports and orthopedic. 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.
1390 1196 490 1101 152 672 1411 1496 1048 1229 271 1455 1434 358 202 1070 1189 929 909 1077 1113 118 1365 464 628 944 1124 203 1380 30 248 49 924 533 1352