Denards rehabilitation protocols arthroscopic shoulder surgery. This protocol provides you with general guidelines for the rehabilitation of patients following a massive open andor arthroscopic rotator cuff repair. Rotator cuff repair rehab protocol the stone clinic. 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.
This may include physical therapy, antiinflammatory medication, rest, and activity modification. These include an inflammatory phase, a proliferative or repair phase, and a remodeling phase. The conservative approach may be associated with postoperative stiffness which can be managed once healing has occurred. 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. The physician will make specific changes to the program as appropriate for an individual patient.
It is designed for rehabilitation following large to massive rotator cuff repairs. Find pdfs of our most common rehabilitation protocols. Rotator cuff repair postoperative rehabilitation protocol orthoindy. Department of rehabilitation services physical therapy arthroscopic rotator cuff repair protocol. Rotator cuff repair surgery can now be performed arthroscopically and is in most. If you have any questions regarding the progress of the patient, the physician should be. 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. Multiple factors can impact the repair, including tissue quality, the age and size. No arom exercise of the shoulder consistent use of sling unless otherwise instructed weaning starting at week 4 at earliest. Rotator cuff repair large to massive 5cm rehabilitation. 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. If initial nonsurgical treatment of a rotator cuff tear fails, surgical repair is often the next line of treatment. Manual laborers will likely be out of work for at least.
Specific interventions should be based on the needs of the individual and should consider exam findings and clinical decision making. 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. Rotator cuff repair postoperative rehabilitation protocol. Rehabilitation protocol for rotator cuff repair massachusetts. This is because the articular surface of the round humeral head is approximately four times greater than that of the. Are there differences between an arthroscopic and open rotator cuff repair. The intent of this protocol is to provide the clinician with a. Brace abduction bracesling, remove sling only to bathe and to complete exercises. 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. Postoperative rotator cuff repair rehabilitation protocol.
Rehabilitation guidelines for type i and type ii rotator. Sports medicine physical therapy rehabilitation protocols. 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. Histological studies suggest that three phases of rotator cuff healing occur after surgical repair. The authors protocol of choice, used within a large sports medicine rehabilitation center, is presented and the rationale behind its implementation is discussed. At your first postop visit you will be given a copy of the operative report which will. Rehabilitation protocol for rotator cuff repair this protocol is intended to guide clinicians and patients through the postoperative course of a rotator cuff repair. For this reason the shoulder is the most mobile joint in the body. Many different factors influence the postoperative rotator cuff repair rehabilitation outcome, including rotator cuff tear size, type of repair, tissue quality, number of. 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. This protocol provides you with general guidelines for the conservative rehabilitation of the patient with a rotator cuff tear rct.
Specific changes in the program will be made by the physician as appropriate for an individual patient. Abduction bracesling, remove sling only to bathe and to. 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. Rotator cuff repair protocol south shore orthopedics. 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. Scapular stabilization exercises sidelying advance to manual resistance. Surgery to repair a torn rotator cuff most often involves reattaching the tendon to the humerus. They attach from the shoulder blade onto the top of the arm bone. Madison, wi 53718 surgical repair of a rotator cuff tear can be done arthroscopically or with a miniopen procedure. It is not intended to be a substitute for clinical decision.
Sling immobilization with supporting abduction pillow to be worn at all times except for showering and rehab under guidance of pt. We provide our patients with comprehensive, coordinated care from experts who understand the unique needs of women in sports. 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 postoperative rehab protocol. Arthroscopic rotator cuff repair protocol brigham and womens. Arthroscopic and open rotator cuff repair rehabilitation protocol week 1 2 shoulder sling and swathe full time day and night. Rotator cuff repair protocol boston shoulder institute.
Progressive early passive and active exercise therapy. The conservative rehabilitation protocol allows sharpey fibers to form before stressing the repair with resistive exercises. 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. 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. Stone invented one of the first suture anchors designed for rotator cuff repair, the questis suture anchor, and has been involved in technique design. 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. 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. Cole,md,mba range of motion immobilizer exercises phase i 04 weeks 02 weeks. Subacromial decompression andor distal clavicle excision in most cases, these procedures are performed in conjunction with another surgery and the rehab. 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 american society of shoulder and elbow therapists. No arom exercise of the shoulder consistent use of sling unless otherwise instructed weaning starting at week 4.
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