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 protocol is both chronologically and criterion based for advancement through four postoperative phases. Shawn hennigan, md rotator cuff repair rehabilitation protocol the following document is an evidencebased protocol for arthroscopic rotator cuff repair rehabilitation. Arthroscopic rotator cuff repair postoperative rehab protocol postoperatively you will be placed in a sling. It is not intended to be a substitute for clinical decision making regarding the progression of a patients postoperative course based. 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. Strengthening of the rotator cuff is done within limits of pain. Rehabilitation protocol for rotator cuff repair this protocol is intended to guide clinicians and patients through the postoperative course of a rotator cuff repair. Avoid provocative maneuvers or exercises that cause discomfort o includes both offending rom exercises and strengthening exercises.
Arthroscopic rotator cuff repair frequently asked questions. It is essential that he or she follow this rehabilitation program very closely. All of the exercises should be performed with slow and controlled motion. 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. Sports medicine physical therapy rehabilitation protocols.
Brace abduction bracesling, remove sling only to bathe and to complete exercises. Move the arm by rocking the body forwardback, side to side, or in a circle. Rotator cuff repair postoperative rehabilitation protocol orthoindy. 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. Rotator cuff repair the following is a protocol for postoperative patients following rotator cuff repair. Remove sling for light activity and home exercise program as indicated by therapist. Arthroscopic rotator cuff repair postoperative rehab protocol. The intent of this protocol is to provide the therapist and patient with guidelines for the postoperative rehabilitation course after arthroscopic rotator cuff repair.
Postoperative rotator cuff repair rehabilitation protocol. Conservative rotator cuff tear protocol sports and orthopedic. Rotator cuff repair with biceps releasetenodesis brian bjerke, md postoperative protocol phase i maximum protection week 0 to 6 goals. 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. Rotator cuff and shoulder rehabilitation exercises. The team at the stone clinic has been repairing rotator cuffs for over twenty years and has progressively improved the techniques. A large size rotator cuff tear is defined as a tear 35cm, massive 5cm. Rotator cuff repair rehab protocol the stone clinic. Sling x 6 weeks ultrasling x 46 weeks, larger tears may be in ultrasling x 6 weeks then. The shoulder rehabilitation protocol consists of two major components. The authors protocol of choice, used within a large sports medicine rehabilitation center. For this reason the shoulder is the most mobile joint in the body. Robertsons office and begin a rehabilitation program.
No arom exercise of the shoulder consistent use of sling unless otherwise instructed weaning starting at week 4 at earliest. Rotator cuff strengthening internal and external rotation isometrics against a wall. Prom as instructed restrictionsexercise progression. A physiotherapist should be consulted throughout to teach and individually modify the exercises. Rotator cuff injury protocols university of california. Talk to your doctor or physical therapist about which exercises will best help you meet your rehabilitation goals. Tear size largemassive tear or 1 tendon repair difficult to achieve full rom, caution with arom and resisted exercises with chroniclarge tears. The socket portion of the joint is not naturally deep. 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. Most rotator cuff tears can be repaired surgically by reattaching the torn tendons to the humerus.
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 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. The intent of this protocol is to provide the clinician with a. 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. 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. Sad subacromial decompression protocol phase i postop until week 2 protective phase. This protocol is intended to guide clinicians and patients through the post operative course of a rotator cuff repair.
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. 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. 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. Johns hopkins shoulder surgery arthroscopic acromioplasty rehabilitation program johns hopkins shoulder surgeons introduction. Purpose of the abductor pillow is to keep tension off of the repair, avoid adduction. 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. Rotator cuff repair small to medium rehabilitation guideline. Immediate postop phase first 57 days after surgery, prior to starting pt goals. Sling immobilization with supporting abduction pillow to be worn at all times except for showering and rehab under guidance of pt. Nonoperative rotator cuff tear protocol acuteearly phase limited, painful arom, painful resisted testing subacutemid phase full arom, minimal to no pain with resisted testing initial evaluation evaluate. Rotator cuff and shoulder conditioning program orthoinfo aaos. It is designed for rehabilitation following small to medium rotator cuff repairs. Three of the four rotator cuff muscles attach from the back of the shoulder blade to the arm bone.
After an injury or surgery, an exercise conditioning. The rotator cuff is responsible for stabilization and active movement of the glenohumeral joint. It is no means intended to be a substitute for ones. Abduction bracesling, remove sling only to bathe and to complete exercises. Treatment should be modified based on the condition of the rotator cuff. Clv pt arthroscopic rotator cuff repair small rehab protocol. This protocol provides you with general guidelines for the conservative rehabilitation of the patient with a rotator cuff tear rct.
This protocol is designed for the patient following arthroscopic rotator cuff repair. One high standard, three local partners for more information go to. Rehabilitation protocol for rotator cuff repair massachusetts. Rotator cuff and shoulder rehabilitation exercises orthoinfo aaos. The conservative rehabilitation protocol allows sharpey fibers to form before stressing the repair with resistive exercises. It is not intended to be a substitute for clinical decision. 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. Do not have the patient perform fullcan or emptycan supraspinatus exercises.
Rehabilitation guidelines for type i and type ii rotator cuff. Cole,md,mba range of motion immobilizer exercises phase i 04 weeks 02 weeks. Rotator cuff repair protocol boston shoulder institute. Rotator cuff repair postoperative rehabilitation protocol. To ensure that this program is safe and effective for you, it should be performed under your doctors supervision. Specific interventions should be based on the needs of the individual and should consider exam findings and clinical decision making. Your surgeon will advise when you should start physiotherapy at your first followup appointment. Rotator cuff repair protocol south shore orthopedics. Supraspinatus open can patient stands with theraband under their foot while grasping theraband, bring shoulders back and down. The shoulder joint is a ball and socket joint that connects. Arthroscopic and open rotator cuff repair rehabilitation protocol week 1 2 shoulder sling and swathe full time day and night. Verma or either physician assistant supersede the instructions below and should be followed.
No resisted rotator cuff strengthening exercises until weeks patients this protocol should be used as a guide during your rehabilitation after surgery. Rehabilitation guidelines for type i and type ii rotator. The primary goal of this protocol is to protect the repair while steadily progressing towards and ultimately achieving preinjury level of activity. This handout serves as a guideline for your rehabilitation after rotator cuff repair. 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.
This protocol is intended to guide clinicians and patients through the postoperative course of a rotator cuff repair. Department of rehabilitation services physical therapy arthroscopic rotator cuff repair protocol. 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. The shoulder is a wonderfully complex joint that is made up of the ball and socket connection. This is because the articular surface of the round humeral head is approximately four times greater than that of the. 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. This is summary of the evaluation and rehabilitation of a patient following an arthroscopic acromioplasty. Those patients with poor rotator cuff tissue integrity, tear of 2. Shawn hennigan, md rotator cuff repair rehabilitation. Johns hopkins shoulder surgery arthroscopic acromioplasty.
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. 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. Arthroscopic rotator cuff repair small tear rehab protocol craig l. Rehabilitation protocol for small to moderate rotator cuff tear. The therapist can provide instruction on patient directed active range of motion, patient directed flexibility, and patient directed.
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