No arom exercise of the shoulder consistent use of sling unless otherwise instructed weaning starting at week 4. Abduction bracesling, remove sling only to bathe and to complete exercises. Rotator cuff repair therapy protocol sideline orthopedics. Most rotator cuff tears can be repaired surgically by reattaching the torn tendons to the humerus. This may be performed arthroscopically or through open surgery, using sutures and bone anchors. Postoperative rotator cuff repair protocoldelayed therapy. Pdf rehabilitation after rotator cuff repair researchgate. Begin passive shoulder rom after surgery beginning week 1 b. No lifting of objects no matter the size or weight. The physician will make specific changes to the program as appropriate for an individual patient. A small size rotator cuff tear is defined as a tear prohaska, m. The rotator cuff is a group of four tendons that attach to the ball of the shoulder joint. Rotator cuff repair postoperative rehabilitation protocol. 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 rehabilitation protocol general ultrasling external rotation er for six weeks at all times, abduction pillow may be removed after four weeks. Remove sling for light activity and home exercise program as indicated by therapist. 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 socket portion of the joint is not naturally deep. The intent of this protocol is to provide the clinician with a. Circumduction reverse codmans lie on your back, use your uninvolved hand to assist your arm to a vertical position you upper arm pointed towards ceiling.
Continue periscapular exercises progressing to manual resistance to all planes. Rotator cuff repair large to massive 5cm rehabilitation. They surround the ball much like the cuff of a sleeve fits snuggly around the wrist. Type ii rotator cuff repair protocol medical staff. Madison, wi 53718 surgical repair of a rotator cuff tear can be done arthroscopically or with a miniopen procedure. Rotator cuff repair rehab protocol the stone clinic. A large size rotator cuff tear is defined as a tear 35cm. Rotator cuff strengthening internal and external rotation isometrics against a wall. It is no means intended to be a substitute for ones.
This protocol will vary in length and aggressiveness depending on factors such as. Rotator cuff repair protocol is a rehabilitation protocol to provide patient with the guidelines following a rotator cuff surgical procedure. Rolf phase i immediate post surgical phase weeks 14. The patient before you is participating in a study to determine the effectiveness of physical therapy in treating rotator cuff tears. Type ii rotator cuff repair protocol arthroscopic tears for large to massive tears 5 cm joseph r. Rotator cuff repair protocol this rehabilitation protocol has been developed for the patient following a rotator cuff surgical procedure. Rotator cuff repair therapy protocol page 1 of 6 bart eastwood d. 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. Aarom and stretching exercises to gain full motion.
Rotator cuff repair protocol south shore orthopedics. Actively rotate your arm clockwise, complete reps, then counterclockwise, keeping your elbow straight. Kate hopman2, lee krahe1, sue lukersmith2, alexander mccoll1, kris vine1. 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. When the arm is moved away from the body or over the head the tendons act to hold the ball in the socket correctly so that smooth fluid motion can be achieved. Size and location of tear degree of shoulder instabilitylaxity prior to surgery. Strengthening of the rotator cuff is done within limits of pain. Shoulder rotator cuff repair oxford university hospitals. Rotator cuff repair postoperative rehabilitation protocol orthoindy. Brace abduction bracesling, remove sling only to bathe and to complete exercises. Postoperative rehabilitation protocol rotator cuff repair. Massive rotator cuff repair rehabitation protocol 3 cm phase i.
It is not intended to be a substitute for clinical decision making regarding the progression of a patients postoperative course based. Minimize pain and inflammatory response achieve rom goals establish stable scapula weeks 0 to 8 1. Clinical practice guidelines for the management of rotator cuff syndrome in the workplace the university of new south wales, medicine, rural clinical school, port macquarie campus 20 research team. The glsm rotator cuff repair rehabilitation program is an evidencebased and soft tissue healing. 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 provides you with general guidelines for the rehabilitation of patients following a massive open andor arthroscopic rotator cuff repair. The shoulder moon group is a multicenter orthopaedic outcomes network, a consortium of institutions working together to bring patients the best possible care with disorders of the shoulder. Preop exercises should be on increasing or maintaining overall rom and muscle activation. Help and feedback was given from people who have had rotator cuff repair surgery. Suite 224a blacksburg, va 24060 54055273 all information contained in. It should be stressed that this is only a protocol and should not be a substitute for clinical decision making regarding a. Many different factors influence the postoperative rotator cuff repair rehabilitation outcome, including rotator cuff tear size, type of repair, tissue quality, number of. Active assist rom beginning week 7 after surgery weeks 78 c.
Rehabilitation protocol for rotator cuff repair massachusetts. This rehabilitation protocol has been developed for the patient following a rotator cuff surgical procedure. Rehabilitation protocol for rotator cuff repair this protocol is intended to guide clinicians and patients through the postoperative course of a rotator cuff repair. Specific interventions should be based on the needs of the individual and should consider exam findings and clinical decision making. Contact dr kevin murphy at 9046340640 to know more. The rotator cuff tendon needs to heal back to bone.
Emphasis should be on proper mechanics and limiting compensatory mechanisms with exercises and activities. Rotator cuff repair protocol shoreline orthopaedics. Conservativelarge rotator cuff repair protocol week one weeks two to three initial evaluation evaluate posture and position of the shoulder girdle passive range of motion inspect for signs of infection, and ensure integrity of the incision assess rtw and sport expectations support physician prescribed meds. The procedure involves stitching the torn tendon back onto its attachment to the humerus. Pate, md arthroscopic rotator cuff repair protocol for. 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. Progress to functional ue protocol as tolerated at completion of phase five. Independent with adls with modifications while maintaining the integrity of the repair. Pate, md arthroscopic rotator cuff repair protocol. If you have any questions regarding the progress of the patient, the physician should be. This is because the articular surface of the round humeral head is approximately four times greater than that of the. Repair guideline background the rotator cuff is responsible for stabilization and active movement of the glenohumeral joint. Purpose of the abductor pillow is to keep tension off of the repair, avoid adduction. Debridement of an acromial bone spur and removal of the inflammed bursa arthroscopic repair of your rotator cuff mini open repair of your rotator cuff deltoid splitting large open repair of your rotator cuff took down deltoid rotator cuff debridement.
Paff, do orthopaedic surgeon upper extremity specialist 370 n 120th ave holland, mi 49424 p 616. Rotator cuff repair small to medium rehabilitation guideline. With abd pillow x 6 weeks for all adls, including sleeping. It is designed for rehabilitation following small to medium rotator cuff repairs. Rehabilitation guidelines for rotator cuff repair and isolated subscapularis repair 2 uwsportsmedicine. Allan hunt phase i 02 weeks maximum protection educate the patient on selfcarehygiene, supporting shoulder with slingabductor support, warning signs including fever, erythema and excessiveunrelenting pain, use of tens unit no motion. The deltoid muscle is separated to expose the torn rotator cuff tendon s. Keep the abductor pillow in for the 4 weeks as well. Clinical practice guidelines for the management of rotator. A gentle rehabilitation protocol with limits in range of motion and exercise times after arthroscopic rotator cuff repair would be better for tendon healing without. Rehabilitation guidelines for type i and type ii rotator. Specific changes in the program will be made by the physician as appropriate for an individual patient. Rotator cuff repair protocol the following procedures were performed. The rate limiting factor in arthroscopic rotator cuff repair is the biologic healing of.
The intent of this protocol is to provide the therapist and patient with guidelines for the postoperative rehabilitation course after arthroscopic rotator cuff repair. Do not have the patient perform fullcan or emptycan supraspinatus exercises. This protocol provides you with general guidelines for the conservative rehabilitation of the patient with a rotator cuff tear rct. Small 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. 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. The team at the stone clinic has been repairing rotator cuffs for over twenty years and has progressively improved the techniques. Rotator cuff repair protocol rotator cuff protocol. Nmes using guidelines at end of protocol o infraspinatus starting 812 weeks o supraspinatus starting 1216 weeks maintain full aprom independent with hep. Rotator cuff repair protocol boston shoulder institute. Size and location of tear degree of shoulder instabilitylaxity prior to surgery acute versus chronic condition.