Prior to rotator cuff repair surgery for rotator cuff tear, you are advised to visit your physiotherapist to make sure you are ready for your postop rehab. Rotator cuff repair protocol south shore orthopedics. This means that it is very rare to have to spend the night in the hospital. Rehabilitation guidelines for type i and type ii rotator. If you have any questions regarding the progress of the patient, the physician should be. This protocol was developed to provide the rehabilitation. 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.
Type ii rotator cuff repair protocol arthroscopic tears for large to massive tears 5 cm joseph r. Paff, do orthopaedic surgeon upper extremity specialist 370 n 120th ave holland, mi 49424 p 616. Stone invented one of the first suture anchors designed for rotator cuff repair, the questis suture anchor, and has been involved in technique design. It is not intended to be a substitute for clinical decision. This protocol provides you with general guidelines for the rehabilitation of patients following a standard open, mini open andor arthroscopic rotator cuff repair. Rehabilitation program following shoulder arthroscopic. Standard open or arthroscopic rotator cuff repair protocol. A rotator cuff repair is designed to improve pain and function in cases of rotator cuff tears. Shawn hennigan, md rotator cuff repair rehabilitation protocol.
Rotator cuff repair rehab protocol the stone clinic. Rotator cuff repair protocol rotator cuff protocol. Accelerated rotator cuff repair protocol 3 applying your sling it may be helpful to support your arm on a firm surface while placing the wedge under the arm of your operated shoulder, however the arm can hang at your side. The deltoid muscle is separated to expose the torn rotator cuff tendon s. Leave your sling on unless your sitting around with your arm propped up in your lap 2. Rotator cuff repair protocol boston sports medicine. Type ii rotator cuff repair protocol medical staff. Rotator cuff repair rehab protocol in the early 1990s, dr. Sports medicinearthroscopic surgery the intent of this protocol is to provide the therapist and patient with guidelines for the postoperative rehabilitation course after arthroscopic rotator cuff repair. Type three rotator cuff repair miniopen or neer approach large to massive tear greater than 5 cm i. Size and location of tear degree of shoulder instabilitylaxity prior to surgery acute versus. Small tear 23 weeks educate that patient should continue to avoid active shoulder. Rehabilitation guidelines for type i and type ii rotator cuff.
Rotator cuff repair protocol northeast orthopedics and. 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. If damage to the rotator cuff is extensive your surgeon may have to use an open incision rather than an arthroscope to complete the procedure. Sling x 6 weeks ultrasling x 46 weeks, larger tears may be in ultrasling x 6 weeks then. Protocol s3 accelerated physical therapy protocol for. No active elevation for 6 weeks or per md orders wear sling for 2 weeks when active avoid abduction aarom x 2 weeks overall goals. This type of rotator cuff tear can usually be repaired but sometimes the tear may not need to be repaired and sometimes cannot be repaired. Rotator cuff repair protocol is a rehabilitation protocol to provide patient with the guidelines following a rotator cuff surgical procedure. Rotator cuff repair protocol the following procedures were performed. Arthroscopic rotator cuff repair protocol small to medium sized tears david j. Brace abduction bracesling, remove sling only to bathe and to complete exercises. Remove sling for light activity and home exercise program as indicated by therapist. 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. This is because the articular surface of the round humeral head is approximately four times greater than that of the.
It should be stressed that this is only a protocol and. Rotator cuff repair protocol rotator cuff repair protocol this rehabilitation protocol has been developed for the patient following a rotator cuff surgical procedure. This rehabilitation program is designed to return the individual to their activities as. This rehabilitation protocol has been developed for the patient following an arthroscopic posterior capsularlabral reconstruction pclr surgical procedure. Type two rotator cuff repair arthroscopic or miniopen medium to large tear greater than 1 cm and less than 5 cm i. Initiate with submax, painfree isometrics and arom as outlined in the protocol.
The intent of this protocol is to provide the clinician with a. The socket portion of the joint is not naturally deep. Control pain, inflammation, and effusion regain normal upper extremity strength and endurance. The team at the stone clinic has been repairing rotator cuffs for over twenty years and has progressively improved the techniques.
It is not intended to be a substitute for clinical decision making regarding the progression of a patients postoperative course based. Contact dr kevin murphy at 9046340640 to know more. Postoperative rehabilitation protocol rotator cuff repair. Position the wedge such that the narrow edge is towards the back of your body. The therapist can provide instruction on patient directed active range of motion, patient directed flexibility, and patient directed strengthening.
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. Shoulder abduction pillowimmobilizer to be worn at all times the first 4 weeks except for exercise. Rotator cuff repair protocol rotator cuff protocol physical. 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. Protect repair decrease paininflammation prevent adhesive capsulitis precautions. For this reason the shoulder is the most mobile joint in the body. Time frames allow for optimal healing and should be used as criteria for advancement along with a patients functional ability. This evidencebased large to massive rotator cuff repair physical therapy guideline. Rotator cuff repair with biceps releasetenodesis brian bjerke, md postoperative protocol phase i maximum protection week 0 to 6 goals. Rotator cuff repair protocol northwestern medical center. Massive rotator cuff repair protocol sports and ortho. This protocol is designed to serve as a patient rehabilitation guide following a standard rotator cuff repair procedure.
Immobilizer on at all times except for therapyhep and sponge bathing. Pate, md arthroscopic rotator cuff repair protocol for. The procedure involves stitching the torn tendon back onto its attachment to the humerus. In supported sitting while awake, the wrist strap can be removed to relax the elbow. This protocol will vary in length and aggressiveness depending on factors such as. Strengthen deltoid, rotator cuff and scapular stabilizers.
Rotator cuff repair is the surgery used to repair a tear in one of these tendons. A torn rotator cuff due to an injury is usually best treated by immediate surgical repair. This rehabilitation protocol has been developed for the patient following a rotator cuff surgical procedure. Shawn hennigan, md rotator cuff repair rehabilitation protocol the following document is an evidencebased protocol for arthroscopic rotator cuff repair rehabilitation. Rotator cuff repair surgery can now be performed arthroscopically and is in most cases an outpatient day surgery procedure. 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 supported pendulum exercises. Phase i immediate postoperative phase weeks 0 6 days 014 patient is seen 2 days postoperative to remove surgical dressings and pain catheter. David schneider, md arthroscopic rotator cuff repair rehabilitation protocol phase i 0 3 weeks goals.
Rotator cuff repair protocol boston shoulder institute. Conservative rotator cuff repair protocol this protocol is designed to serve as a patient rehabilitation guide following a massive or fragile rotator cuff repair procedure. This procedure is normally the result of extreme laxity in the posterior capsule requiring surgical intervention to shrink the area. Massive rotator cuff repair rehabitation protocol 3 cm. August 2010 orthocarolina rotator cuff repair protocol massive typically a massive rotator cuff tear is defined as a tear 5cm. This may be performed arthroscopically or through open surgery, using sutures and bone anchors. Rotator cuff repair postoperative rehabilitation protocol. Vcu sports medicine clinic standard rotator cuff repair protocol.
If you have any questions regarding the progress of the patient, the. The protocol is both chronologically and criterion based for advancement through four postoperative phases. Subscapularis muscle activity during selected rehabilitation exercises. Size and location of tear degree of shoulder instabilitylaxity prior to surgery acute versus chronic condition. The rotator cuff can also wear out as a result of degenerative changes. Showering is allowed once dressings and catheter is removed. Rehabilitation protocol for rotator cuff repair massachusetts. Rotator cuff repair a rotator cuff repair is designed to improve pain and function in cases of rotator cuff tears. Rotator cuff repair small tear protocol phase i 06 week 1. 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. Rotator cuff repair protocol1 northwestern medical center. This protocol provides you with general guidelines for the rehabilitation of patients following a massive open andor arthroscopic rotator cuff repair. Size and location of tear degree of shoulder instabilitylaxity prior to surgery.
Do not add, alter, or skip any of the treatments in this protocol. Shoulder abduction pillowimmobilizer to be worn at all times the first 4 weeks except for exercise and hygiene therapeutic exercise. Arthroscopic rotator cuff repair protocol medium to large. Rotator cuff repair protocol shoreline orthopaedics.
Murphy, md board certified orthopedic surgeon specializing in sports medicine and arthroscopy 10475 centurion pkwy. Some surgeons may also define a massive rotator cuff tear based on poor tissue quality, poor bone quality or when more than one muscle is involved. Rotator cuff repair protocol this rehabilitation protocol has been developed for the patient following a rotator cuff surgical procedure. Specific changes in the program will be made by the physician as appropriate for an individual patient. Partialthickness tear and small fullthickness tears. Rotator cuff repair postoperative rehabilitation protocol orthoindy. 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. 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. Most rotator cuff tears can be repaired surgically by reattaching the torn tendons to the humerus. 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. Prom as instructed restrictionsexercise progression. The rotator cuff tendon needs to heal back into the bone rom goals. Maintain arm in brace, remove for exercise diminish pain and inflammation no lifting with involved arm prevent muscular inhibition no excessive shoulder extension no aggressive stretching or sudden movt. This protocol is intended to guide clinicians and patients through the post operative course of a rotator cuff repair.
Protocol s3 accelerated physical therapy protocol for rotator. Protocol s3 accelerated physical therapy protocol for rotator cuff repair arthroscopic or miniopen technique recommended for mild. You may add motrin, aleve if you have no stomach problems in between doses as needed. Abduction bracesling, remove sling only to bathe and to complete exercises.
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