The intent of this protocol is to provide the clinician with a. The best rotator cuff strengthening routine bulletproof. Among most common causes of shoulder pain and instability. The postoperative protocol after arthroscopic rotator cuff repair arcr is still controversial. Rotator cuff repair protocol boston shoulder institute. Rotator cuff repair protocol northeast orthopedics and sports. An abduction splint which holds the arm away from the body. Rotator cuff repair rehabilitation program download pdf version. Numerous rehabilitation protocols for the management of rotator cuff disease are based primarily on clinical experience and expert opinion. Maximise shoulder strength of deltoid, intact cuff muscles and scapula stabilisers. The suturesanchors hold the tendons so they can heal back to the bone. No arom exercise of the shoulder consistent use of sling unless otherwise instructed weaning starting at week 4 at earliest. Sling usedriving do not attempt to lift the operative arm without assistance or use the muscles in the operative shoulder i.
All exercises were placed in a theoreticalcontinuum model, by which general recommendations could be made for prescription in patients post rotator cuff repair. No arom exercise of the shoulder consistent use of sling unless otherwise instructed weaning starting at week 4. Incidence 540% with increasing with advancing age 40 years. Rotator cuff repair the following is a protocol for postoperative patients following rotator cuff repair. Rehabilitation, arthroscopic rotator cuff repair, shoulder, scientific rationale, rehabilitation protocols, tendon healing. Repair of rotator cuff tears uw orthopaedics and sports. Rotator cuff and shoulder rehabilitation exercises. Tears are considered massive when they involve multiple tendons. Read about rotator cuff repair rehabilitation program. Rehabilitation of the shoulder after rotatorcuff repair. Postoperative rehabilitation guidelines for rotator cuff tears. Rehabilitation after rotator cuff repair the open orthopaedics journal, 2017, volume 11 155 outpatient procedure and mainly enables secure fixation and sequentially early return to motion 3, 4. I tore it playing basketball in september, but wanted to see how it responded without surgery before committing to a.
Following a wellstructured conditioning program will also help you return to sports and other. Rehabilitation protocol for rotator cuff repair this protocol is intended to guide clinicians and patients through the postoperative course of a rotator cuff repair. Massive delayed rotator cuff repair general instructions for therapists. Protocol for a multicentre pilot and feasibility randomised controlled trial with a nested qualitative study. Rotator cuff repair is the surgery used to repair a tear in one of these tendons. After an injury or surgery, an exercise conditioning program will help you return. In rotator cuff repair surgery one or more of these muscles are reattached to the bone using anchorssutures. The rotator cuff is made up of 4 muscles supraspinatus, infraspinatus, subscapularis, and teres minor that help stabilize the shoulder. If pain, weakness, and stiffness in your shoulder see figure in appendix are related to problems with your rotator cuff, a doctor will usually first recommend nonsurgical treatment. I havent posted about this because it falls under the second line in my signature, but im almost two weeks post surgery to repair a torn rotator cuff supraspinatus tendon. Therapy is to being 2 weeks after the surgery for this protocol. No prom of shoulder for first 3 weeks except pendulums. Rotator cuff repair denver rotator cuff tears aurora.
Outcomes of combined arthroscopic rotator cuff and labral. 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 after arthroscopic rotator cuff repair. The clinical outcomes of the surgical methods of rotator cuff repair open, miniopen, and allarthroscopic cuff repair vary, as each method provides an.
Rotator cuff repair rehabilitation garner rotator cuff surgery. Rotator cuff repair rehabilitation rosenberg cooley metcalf. Rotator cuff repair with biceps releasetenodesis brian bjerke, md postoperative protocol phase i maximum protection week 0 to 6 goals. Verma or either physician assistant supersede the instructions below and should be followed. An evaluationbased approach abstract rotator cuff disease of the shoulder, a common condition, is often incapacitating. Romeo, md, and bernard bach, jr, md normal shoulder function requires a balanced relationship between glenohumeral mobility and glenohumeral stability. Rotator cuff repair protocol south shore orthopedics. No arom exercise of the shoulder consistent use of sling unless otherwise instructed weaning starting at week 4 at earliest pendulum exercises, elbow aarom and gripping 4x per day starting pod 3. 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. Rotator cuff and shoulder conditioning program orthoinfo aaos.
Continue passive motion as needed until full range of motion, then start aarom and advance to full arom. Synchronized or isolated protocol the primary goal of postsurgical rehabilitation following rotator cuff repair is to control pain, protect repaired tissue during the healing process, restore function, improve rangeofmotion, restore strength and prevent a. Postoperative rehabilitation guidelines for rotator cuff tears please note that these instructions are general guidelines to be followed. Is rehabilitation effective in massive rotator cuff tears. Department of rehabilitation services physical therapy arthroscopic rotator cuff repair protocol. Surgery for shoulders with torn rotator cuff tendons can lessen shoulder pain and improve function without acromioplasty download.
The conservative rehabilitation protocol allows sharpey fibers to form before stressing the repair with resistive exercises. Symptoms of rotator cuff injuries people of all ages injure their rotator cuffs. Rehabilitation guidelines for type i and type ii rotator cuff. Patients with irreparable tears and shoulder pseudoparalysis may be offered rehabilitation therapy. The team at the stone clinic has been repairing rotator cuffs for over twenty years and has progressively improved the techniques. Rotator cuff repair denver rotator cuff tears aurora denver. Backgroundrotator cuff tears, bankart lesions, and superior labral anterior posterior lesions commonly occur in isolation, but there is a subgroup of patients who experience combined injuries. Routine early rotator cuff repair general instructions for therapists. Rotator cuff repair protocol boston sports medicine. Open, miniopen, and allarthroscopic rotator cuff repair. The goal of these videos is to help maximize your recovery following rotator cuff surgery. Postsurgical outcomes for patients having had rotator cuff repair can be quite good. Strengthening the muscles that support your shoulder will help keep.
Clinical guidelines for cpm following rotator cuff repair. These videos should not be used as a substitute for regular physical therapy visits and guidance from your physician. Pictures courtesy of simpleset, used with permission. Backgroundrotator cuff tears, bankart lesions, and superior labral anterior posterior lesions commonly occur in isolation, but there is a subgroup of. The shoulder joint is a ball and socket joint that connects the. Rehabilitation following rotator cuff repair introduction rehabilitation following cuff repair rehab plan rotator cuff repairs in overhead throwers conway. Wound care as outlined on the shoulder arthroscopy rehabilitation page. Pdf rehabilitation after rotator cuff repair researchgate. Therapy is to being 6 weeks after the surgery for this protocol. A successful outcome is much dependent on surgical technique as it is on rehabilitation.
Whether nonsurgical or surgical, successful management of rotator cuff disease is dependent on appropriate. Talk to your doctor or physical therapist about which exercises will best help you meet your rehabilitation goals. Rotator cuff repair rehabilitation rosenberg cooley. 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. The conservative approach may be associated with postoperative stiffness which can be managed once healing has occurred. Routine early rotator cuff repair massive delayed rotator cuff repair.
Click here to download a pdf version of the rotator cuff repair rehabilitation guide. Pdf rehabilitation after arthroscopic rotator cuff repair. Some surgeons recommend slower rehabilitation in order to improve the integrity of the repair, while others prefer early rangeofmotion rom exercise to avoid postoperative stiffness. Out of activeassisted exercises, 9 were identified as suitable 15% mvic or less to load the supraspinatus and 10 as suitable to load the infraspinatus early after surgery. Sling x 6 weeks ultrasling x 46 weeks, larger tears may be in ultrasling x 6 weeks then. Shawn hennigan, md rotator cuff repair rehabilitation protocol the following document is an evidencebased protocol for arthroscopic rotator cuff repair rehabilitation. Phase ii weeks 48 discontinue sling immobilization range of motion o. Manual laborers will likely be out of work for at least six months. The impact of rotator cuff tears on range of motion depends on the site of the lesions. Introduction in 1834, smith first description of a rupture of the rotator cuff tendon.
The current literature on tissue engineering application for rotator cuff repair is scanty. The clinical outcomes of the surgical methods of rotator cuff repair open, miniopen, and allarthroscopic cuff repair vary, as each method provides an array of advantages and disadvantages. Surgery for shoulders with torn rotator cuff tendons can lessen shoulder pain and improve function without acromioplasty download this article as a pdf. Target range of motion at 3 months after arthroscopic. Whether nonsurgical or surgical, successful management of rotator cuff disease is dependent on appropriate rehabilitation. The protocol is both chronologically and criterion based for advancement through four postoperative phases. Rotator cuff repair arthroscopic this protocol is based on maintaining range of movement in the first phase and then gradually building strength in the middle to the last phase. Rotator cuff repair rehab protocol the stone clinic. Pdf to provide an overview of the characteristics and timing of rotator cuff healing and provide an. Failure of rehabilitation therapy is common in patients with massive anterior tears or tears involving at least three tendons.
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. Feb 20, 2017 i havent posted about this because it falls under the second line in my signature, but im almost two weeks post surgery to repair a torn rotator cuff supraspinatus tendon. Remove sling for light activity and home exercise program as indicated by therapist. Rehabilitation after rotator cuff repair the open orthopaedics. 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. Rehabilitation guidelines for type i and type ii rotator. Orthop no am 01 14 baseball players pitchers intratendinous repair average follow up 16 mos 89 89% followed for 1 yr or more returned to preinjury level. The above exercises can be performed as a routine 23 times per week, and are summarized with tutorials in the below pdf. Specific interventions should be based on the needs of the individual and should consider exam findings and clinical decision making. Exercises you can do at home exercises are a very important part of treatment for a rotator cuff disorder. Rotator cuff repair rehabilitation garner rotator cuff.
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. Shawn hennigan, md rotator cuff repair rehabilitation protocol. Jul 14, 2019 the above exercises can be performed as a routine 23 times per week, and are summarized with tutorials in the below pdf. Postoperative rotator cuff repair rehabilitation protocol. The goal of rotator cuff repair is to eliminate pain and improve function with increased shoulder strength and range of motion. Sling immobilization with supporting abduction pillow to be worn at all times except for showering and rehab under guidance of pt o therapeutic exercise o elbowwristhand range of motion and grip strengthening.