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. It is not intended to be a substitute for clinical decision making regarding the progression of a patients postoperative course based. Rotator cuff repair therapy protocol page 1 of 6 bart eastwood d. The rate limiting factor in arthroscopic rotator cuff repair is the biologic healing of. Pate, md arthroscopic rotator cuff repair protocol. Specific changes in the program will be made by the physician as appropriate for an individual patient. Rotator cuff repair rehabilitation protocol general ultrasling external rotation er for six weeks at all times, abduction pillow may be removed after four weeks. It is designed for rehabilitation following small to medium rotator cuff repairs. Rotator cuff repair protocol shoreline orthopaedics. Nmes using guidelines at end of protocol o infraspinatus starting 812 weeks o supraspinatus starting 1216 weeks maintain full aprom independent with hep. Specific interventions should be based on the needs of the individual and should consider exam findings and clinical decision making. Purpose of the abductor pillow is to keep tension off of the repair, avoid adduction. 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.
Size and location of tear degree of shoulder instabilitylaxity prior to surgery acute versus chronic condition. Rehabilitation protocol for rotator cuff repair massachusetts. Rotator cuff repair postoperative rehabilitation protocol orthoindy. 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. Progress to functional ue protocol as tolerated at completion of phase five. This is because the articular surface of the round humeral head is approximately four times greater than that of the. Rotator cuff repair protocol south shore orthopedics. It should be stressed that this is only a protocol and should not be a substitute for clinical decision making regarding a. This rehabilitation protocol has been developed for the patient following a rotator cuff surgical procedure. Rolf phase i immediate post surgical phase weeks 14. 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. Active assist rom beginning week 7 after surgery weeks 78 c.
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. It is designed for rehabilitation following large to massive rotator cuff repairs. Aarom and stretching exercises to gain full motion. Time frames allow for optimal healing and should be used as criteria for advancement along with a patients functional ability. 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. Repair guideline background the rotator cuff is responsible for stabilization and active movement of the glenohumeral joint. The intent of this protocol is to provide the therapist and patient with guidelines for the postoperative rehabilitation course after arthroscopic rotator cuff repair.
If you have any questions regarding the progress of the patient, the physician should be. Independent with adls with modifications while maintaining the integrity of the repair. It is no means intended to be a substitute for ones. Madison, wi 53718 surgical repair of a rotator cuff tear can be done arthroscopically or with a miniopen procedure. Strengthening of the rotator cuff is done within limits of pain. Many different factors influence the postoperative rotator cuff repair rehabilitation outcome, including rotator cuff tear size, type of repair, tissue quality, number of. Keep the abductor pillow in for the 4 weeks as well. Postoperative rehabilitation protocol rotator cuff repair. 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. 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 protocol rotator cuff protocol. Shoulder rotator cuff repair oxford university hospitals. Help and feedback was given from people who have had rotator cuff repair surgery. The intent of this protocol is to provide the clinician with a. A large size rotator cuff tear is defined as a tear 35cm. Rehabilitation guidelines for type i and type ii rotator. Rotator cuff strengthening internal and external rotation isometrics against a wall. The procedure involves stitching the torn tendon back onto its attachment to the humerus.
Suite 224a blacksburg, va 24060 54055273 all information contained in. Rotator cuff repair rehab protocol the stone clinic. Emphasis should be on proper mechanics and limiting compensatory mechanisms with exercises and activities. Type ii rotator cuff repair protocol arthroscopic tears for large to massive tears 5 cm joseph r. Pdf rehabilitation after rotator cuff repair researchgate. Standard rotator cuff repair protocol this protocol is designed to serve as a patient rehabilitation guide following a standard rotator cuff repair procedure. Begin passive shoulder rom after surgery beginning week 1 b. The glsm rotator cuff repair rehabilitation program is an evidencebased and soft tissue healing. Rotator cuff repair small to medium rehabilitation guideline. With abd pillow x 6 weeks for all adls, including sleeping. Initiate manual resistance er in supine in scapular plane light resistance.
Brace abduction bracesling, remove sling only to bathe and to complete exercises. 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. This protocol will vary in length and aggressiveness depending on factors such as. Abduction bracesling, remove sling only to bathe and to complete exercises. No lifting of objects no matter the size or weight. For this reason the shoulder is the most mobile joint in the body. Rotator cuff repair protocol this rehabilitation protocol has been developed for the patient following a rotator cuff surgical procedure. 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. Minimize pain and inflammatory response achieve rom goals establish stable scapula weeks 0 to 8 1. Rehabilitation protocol for rotator cuff repair this protocol is intended to guide clinicians and patients through the postoperative course of a rotator cuff repair.
Rotator cuff repair protocol boston shoulder institute. Preop exercises should be on increasing or maintaining overall rom and muscle activation. Paff, do orthopaedic surgeon upper extremity specialist 370 n 120th ave holland, mi 49424 p 616. Remove sling for light activity and home exercise program as indicated by therapist. Continue periscapular exercises progressing to manual resistance to all planes. 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. Size and location of tear degree of shoulder instabilitylaxity prior to surgery. Massive rotator cuff repair rehabitation protocol 3 cm phase i. Do not have the patient perform fullcan or emptycan supraspinatus exercises. 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. Type ii rotator cuff repair protocol medical staff. Rotator cuff repair postoperative rehabilitation protocol. Pate, md arthroscopic rotator cuff repair protocol for. The patient before you is participating in a study to determine the effectiveness of physical therapy in treating rotator cuff tears.
The deltoid muscle is separated to expose the torn rotator cuff tendon s. This protocol provides you with general guidelines for the rehabilitation of patients following a massive open andor arthroscopic rotator cuff repair. The team at the stone clinic has been repairing rotator cuffs for over twenty years and has progressively improved the techniques. Contact dr kevin murphy at 9046340640 to know more. No arom exercise of the shoulder consistent use of sling unless otherwise instructed weaning starting at week 4. A small size rotator cuff tear is defined as a tear prohaska, m. The rotator cuff tendon needs to heal back to bone. The rotator cuff is a group of four tendons that attach to the ball of the shoulder joint. Rehabilitation guidelines for rotator cuff repair and isolated subscapularis repair 2 uwsportsmedicine.
The physician will make specific changes to the program as appropriate for an individual patient. 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. 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. Rotator cuff repair large to massive 5cm rehabilitation.
Clinical practice guidelines for the management of rotator. 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. Rotator cuff repair therapy protocol sideline orthopedics. Rotator cuff repair protocol is a rehabilitation protocol to provide patient with the guidelines following a rotator cuff surgical procedure. Postoperative rotator cuff repair protocoldelayed therapy. This protocol was developed to provide the rehabilitation professional with a. Kate hopman2, lee krahe1, sue lukersmith2, alexander mccoll1, kris vine1. The socket portion of the joint is not naturally deep. Actively rotate your arm clockwise, complete reps, then counterclockwise, keeping your elbow straight. This may be performed arthroscopically or through open surgery, using sutures and bone anchors. Most rotator cuff tears can be repaired surgically by reattaching the torn tendons to the humerus. Rotator cuff repair protocol the following procedures were performed. This protocol provides you with general guidelines for the conservative rehabilitation of the patient with a rotator cuff tear rct.
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. 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. They surround the ball much like the cuff of a sleeve fits snuggly around the wrist. 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. 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.
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