For many people, physical therapy pt is the answer. Domb would like to personally thank you in advance for taking care of our mutual patient postoperatively. Prospective randomized study of arthroscopic rotator cuff repair using an early versus delayed postoperative physical therapy protocol. The first classification is a partial thickness or. The rotator cuff is made up of four muscles supraspinatus, infraspinatus, subscapularis, and teres minor and their tendons. Rotator cuff repair therapy protocol sideline orthopedics. Rotator cuff repair physical therapy protocol preoperative guidelines restore arom strengthen involved extremity in pain free rom, emphasize rotator cuffscapular stabilization musculature instruct in use of abduction pillow immobilizer, icing, hand gripping, elbow rom educate patient on postop protocol and importance of compliance for good. 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. Shoulder tendonitis center for sports medicine and.
Clv pt arthroscopic rotator cuff repair small rehab protocol. Rehabilitation guidelines for type i and type ii rotator cuff. Start against gravity and gradually progress with weights. This handout serves as a guideline for your rehabilitation after rotator cuff repair. Physical therapy prescription arthroscopic rotator cuff. The intent of this protocol is to provide guidelines for your patients therapy progression. The rotator cuff tendon needs to heal back into the bone rom goals.
There will always be individual differences amongst patients regarding progression and tolerance of specific activities. The physician will make specific changes to the program as appropriate for an individual patient. Rotator cuff tears can be classified in various ways. Jan 31, 2020 the goal of treating a rotator cuff tear is not necessarily to heal the torn tendon. Rehabilitation guidelines for type i and type ii rotator. 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. Rehabilitation protocol for reverse shoulder arthroplasty. The physiotherapist must exercise their best professional judgment to determine how to. Passive range of motion shoulde r fle xi onsc a pt i on 070 degree s, e xt e rnal rot a t i on to 30 degre e s. To ensure that this program is safe and effective for you, it should be performed under your doctors supervision. Pt is a way to get back strength and movement after an injury.
Large rotator cuff repair protocol fowler kennedy sport. Rotator cuff physical therapy guidelines and protocol general guidelines. Performs all exercises demonstrating symmetric scapular mechanics. Specific variations may be appropriate for each patient and may be specified by the physician. Arthroscopic rotator cuff repair protocol medium to large. Rehabilitation protocol for rotator cuff repair massachusetts. 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.
South shore hospital orthopedic, spine and sports therapy in clinical collaboration with south shore orthopedics page 1. A large size rotator cuff tear is defined as a tear 35cm, massive 5cm. Physical therapy prescription arthroscopic rotator cuff repair moon multicenter orthopaedic outcomes network immediate red protocol. People can often achieve pain relief and improved strength by relieving inflammation and restoring shoulder joint mechanics. Rotator cuff and shoulder rehabilitation exercises pdf handout. Considerations for the postoperative rotator cuff repair rehabilitation program. 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. This protocol provides you with general guidelines for the conservative rehabilitation of the patient with a rotator cuff tear rct. Can physical therapy help repair a rotator cuff tear. Abduction bracesling, remove sling only to bathe and to complete exercises. Specific interventions should be based on the needs of the individual and should consider exam findings and clinical decision making. This is because the articular surface of the round humeral head is approximately four times greater than that of the. Interval throwing program for little league age athletes. Strengthening all exercises painfree rom only 3xweek max.
This protocol is designed for the patient following arthroscopic rotator cuff repair. Arthroscopic rotator cuff repair small tear rehab protocol craig l. Talk to your doctor or physical therapist about which exercises will best help you meet your rehabilitation goals. Rotator cuff and shoulder conditioning program orthoinfo aaos. Brace abduction bracesling, remove sling only to bathe and to complete exercises.
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. 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. This can be accomplished with physical therapy and antiinflammatory treatments, including medications, cortisone injections, and ice. A referral for physical therapy is usually provided by a shoulder specialist, but your family physician may write a script to pt prior to sending you for further tests to confirm a rotator cuff tear.
Initiating rotator cuff and scapula stabilization strengthening exercises should be. Prospective randomized study of arthroscopic rotator cuff. 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. However, the rotator cuff tear size, muscle atrophy, and fatty infiltration may progress. Jazrawi, md associateprofessoroforthopaedics chief2divisionofsportsmedicine tel. At this point you should begin your formal physical therapy, the instructions that follow are to aid your. Specific changes in the program will be made by the physician as appropriate for an individual patient. Rotator cuff repair protocol boston shoulder institute. Immediate postop phase first 57 days after surgery, prior to starting pt goals. Rotator cuff repair protocol rotator cuff protocol physical. 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. It is no means intended to be a substitute for ones. This process alone can lead to rotator cuff tears in older patients.
Avoid provocative maneuvers or exercises that cause discomfort o includes both offending rom exercises and strengthening exercises. The intent of this protocol is to provide the clinician with a. 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. Dec 10, 2017 rotator cuff physical therapy varies depending on the stage of injury and whether you have had surgery to repair the shoulder. Suite 224a blacksburg, va 24060 54055273 all information contained in this protocol is to be used as general guidelines only. Rotator cuff repair protocol rotator cuff protocol. Patients over 50 years of age are more susceptible to sustaining a significant rotator cuff tear from trauma. Exercises to strengthen the shoulder may help to prevent a recurrence. Move the arm by rocking the body forwardback, side to side, or in a circle. Early passive range of motion of the glenohumeral joint to prevent capsular adhesions is essential. Rotator cuff physical therapy guidelines and protocol. Rotation medical patch rehabilitation protocol phase i.
Begin the second phase of rehabilitation with these strengthening exercises once you have. Your doctor may send you to a physical therapist for exercises or other therapy. Progression through the protocol will depend on successful accomplishments of set milestones as assessed by the. It may be all you need to treat an injured rotator cuff. Conservative rotator cuff tear protocol sports and orthopedic. Rotator cuff postoperative rehabilitation protocol general considerations.
Physical therapy arthroscopic rotator cuff repair protocol. This study performed a prospective, randomized evaluation of patient outcomes and rotator cuff healing after arthroscopic rotator cuff repair using a postoperative physical therapy protocol with early passive motion compared with a delayed protocol that limits early passive motion. Rotator cuff repair protocol is a rehabilitation protocol to provide patient with the guidelines following a rotator cuff surgical procedure. Rotator cuff repair postoperative rehabilitation protocol orthoindy. The goal of treating a rotator cuff tear is not necessarily to heal the torn tendon.
Surgery may be required to treat shoulder tendinitis and bursitis if it becomes chronic or if there is a tear of the rotator cuff. At that time, they will help you schedule a physical therapy appointment at utsw. The deltoid muscle is separated to expose the torn. Rotator cuff repair protocol south shore orthopedics. This protocol provides you with general guidelines for the rehabilitation of patients following a massive open andor arthroscopic rotator cuff repair. Rotator cuff physical therapy varies depending on the stage of injury and whether you have had surgery to repair the shoulder. Prone scapular retraction exercises without weights. Clinic appointments at 8 to 12 days, then at 6 weeks, 12 weeks, 18 weeks and possibly 24 weeks postop physical therapy appointment starting at 2 weeks, lasting 12 to 18 weeks acute phase. This study evaluated patient outcomes and rotator cuff healing after arthroscopic rotator cuff repair using a postoperative physical therapy protocol with early passive motion compared with a. 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 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.
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. 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 patient, clinician and physical therapist with a guideline of the postoperative rehabilitation course of a patient that has undergone an. No arom exercise of the shoulder consistent use of sling unless otherwise instructed weaning starting at week 4 at earliest. Exercises and physical therapy for rotator cuff tear. Application of ice and tens for pain control at end of therapy session and at frequency of 4x day at home. Rehabilitation protocol for reverse shoulder arthroplasty this protocol is intended to guide clinicians and patients through the postoperative course after a reverse shoulder arthroplasty. Rotator cuff repair postoperative rehabilitation protocol. Contact dr kevin murphy at 9046340640 to know more. Rotator cuff tendonitisimpingement rehabilitation protocol. Specific interventions should be based on the needs of the individual and should consider exam. If you have any questions regarding the progress of the patient, the physician should be. The rotator cuff is responsible for stabilization and active movement of the glenohumeral joint.
Standard rotator cuff repair physical therapy philosophy this protocol is to be utilized as a guideline. Rotator cuff sprain and strains university of california. Rotator cuff and shoulder rehabilitation exercises. However, the rotator cuff tear size, muscle atrophy, and fatty infiltration may progress over 5 to 10 years with non operative management. Those patients with poor rotator cuff tissue integrity, tear of 2. Orthopaedic surgery, sports medicine and rehabilitation rotator cuff re pai r postoperative physical therapy protocol exercise. 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. Rotator cuff repair therapy protocol page 1 of 6 bart eastwood d. Physical therapy standards of care brigham and womens. Should you wish to perform therapy elsewhere, you should make arrangements to start therapy days following this visit.
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