A full or partial thickness tear in the tendon or muscle of one or more of the rotator cuff muscles a group of smaller muscles that help mainly stabilize the ball in the socket of the shoulder joint often requires a surgical repair. Postoperative rehabilitation guidelines for rotator cuff tears arthroscopic rotator cuff repair arthroscopic assisted miniopen rotator cuff repair 14 weeks. Jses 2004 84% vs 30% rehabilitation following rotator cuff repair introduction whats the concern about early. The clinical effect of arthroscopic rotator cuff repair. Physicians develop new technique for rotator cuff repair at. It is important that this communication should continue throughout the whole recovery process. Rehabilitation following rotator cuff repair begins with a close communication between the surgeon, the patient and the physical therapy team. Begin with clear liquids and light foods jellos, soups, etc.
Rotator cuff repair rehab protocol the stone clinic. This protocol was designed to provide the rehabilitation professional with a guideline of postoperative care. Sling immobilization with supporting abduction pillow to be worn at all times except for showering and rehab under guidance of pt. After making one or two very small cuts in your skin, a surgeon will insert a tiny camera called an arthroscope and special, thin tools into your shoulder.
Repair guideline background the rotator cuff is responsible for stabilization and active movement of the glenohumeral joint. These exercises are intended for the initial strengthening of acute shoulder problems, andor longterm rehabilitation for massive rotator cuff tears and other conditions resulting in longterm severe weakness. P population patients in post operative rehabilitation after rotator cuff repair. Welcome to our rotator cuff repair rehabilitation video series. Rehabilitation program following rotator cuff repair 3 use of the ultrasling the ultrasling is designed to keep your operated shoulder in a comfortable position, away from your body, after your surgery.
Keep the abductor pillow in for the 4 weeks as well. Phase 1 sling 1 full time use for 6 weeks 2 sleep in sling until after week 6 3 discontinue only after week 6 weeks 06 1 passive motion only beginning first postoperative day. Read online rotator cuff rehabilitation therapist directed program book pdf free download link book now. Rotator cuff tears do not heal, or repair themselves. To compare two different rehabilitation strategies, primary. Regain normal strength and painfree function of the shoulder.
Physicians develop new technique for rotator cuff repair at the andrews institute. Rehabilitation, arthroscopic rotator cuff repair, shoulder, scientific rationale. Shoulder rehabilitation after the surgery nordorthopaedics. An evaluationbased approach abstract rotator cuff disease of the shoulder, a common condition, is often incapacitating. All books are in clear copy here, and all files are secure so dont worry about it. A rotator cuff repair involves stitching the torn tendon back onto its attachment to the arm bone humerus. Some patients with rotator cuff tears have little or no pain. 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. For the first month after the rotator cuff repair surgery a patient wears a sling and no movement is allowed until partial recovery is achieved. Rehabilitation following rotator cuff repair keys to success rehabilitation following cuff repair maximizing tendon healing biomechanical factors biologic factors patient factors effect of smoking on rotator cuff repairs mallon et al. Whether nonsurgical or surgical, successful management of rotator cuff disease is dependent on appropriate rehabilitation. Rotator cuff repair protocol south shore orthopedics. The conservative approach may be associated with postoperative stiffness which can be managed once healing has occurred. Repair of rotator cuff tears uw orthopaedics and sports.
Find out how physical therapy exercises and other treatment can help you feel better. Full thickness rotator cuff tears are rarely seen in those younger than 40 years of age. The primary goal of this protocol is to protect the repair while steadily progressing towards and ultimately achieving preinjury level of activity. Arthroscopic rotator cuff repair shoulderdoc by prof. Rotator cuff surgery is the repair of inflammation or tears of the rotator cuff tendons in the shoulder. Rotator cuff repair a rotator cuff repair is designed to improve pain and function in cases of rotator cuff tears.
The intent of this protocol is to provide the clinician with a guideline to establish and progress a patient through post operative rehabilitation. Use a weight that makes the last few repetitions difficult, but painfree. Information in reinolds webinar and ajsm article may change the face of these protocols. The four shoulder muscles that make up the rotator cuff can get worn or tear. Despite enormous interest in determining factors that would correlate with improved patient outcomes, satisfaction, and function after arthroscopic rotator cuff repair arcr, relatively little is known about the influence of postoperative rehabilitation protocols on tendon healing and functional outcome. Rotator cuff and shoulder conditioning program orthoinfo aaos.
Surgery for shoulders with torn rotator cuff tendons can lessen shoulder pain and improve function without acromioplasty download this article as a pdf. This may be performed arthroscopically or through open surgery, using sutures and bone anchors. The goals of rehabilitation are first to protect the repair and second to restore pain free. Maintain your operative dressing, loosen bandage if swelling of the elbow, wrist, or hand occurs. Are pulley exercises initiated 6 weeks after rotator cuff.
Progress to your normal diet if you are not nauseated. The conservative rehabilitation protocol allows sharpey fibers to form before stressing the repair with resistive exercises. The shoulder is a wonderfully complex joint that is made up of the ball and socket connection. Rehabilitation protocol for total shoulder arthroplasty. Phase 1 initial 3 weeks postsurgery patient is immobilized for initial 3 weeks. Patients in the seventh decade have a 50% prevalence of rotator cuff tears which increases to over 80% in patients in the eighth decade of life. It is technically demanding but allows for less pain, early rehabilitation and minimal scars and has equal tendon healing rates as open surgery. Rotator cuff disorders, including rotator cuff tears, are common and can be treated conservatively or surgically. Anterior and posterior interval slides were used to allow the free margin of the rotator cuff to converge toward the bony footprint and facilitate repair. Department of rehabilitation services physical therapy arthroscopic rotator cuff repair protocol.
Rehabilitation release the sizeweight of the arm penn shoulder and elbow service presbyterian medical center rotator cuff repair rom exercises and movement can over tension the repair rotator interval external rotation with arm at side will tension interval and cuff repair. Pdf background tears and lesions of the rotator cuff are a frequent cause of shoulder. Kyle r flik, md postoperative rehabilitation guidelines for. Rotator cuff repair rehabilitation garner rotator cuff surgery. Some of the most important muscles for this purpose are the rotator cuff muscles.
Arthroscopic or key hole surgery of the shoulder allows for excellent visualisation of the rotator cuff tear and its repair in a minimally invasive manner. In fact, some rotator cuff tears will increase in size if. Guide to rotator cuff repair rehabilitation welcome to our rotator cuff repair rehabilitation video series. 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. Complete ruptures usually require surgery if your goal is to return your shoulder to optimal function. The goal of these videos is to help maximize your recovery following rotator cuff surgery. Rotator cuff and shoulder rehabilitation exercises. Acute tears with early repair may have a slightly greater susceptibility to develop stiffness, but it has also been noted that these patients progress with rehabilitation more rapidly than those with late repair. 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. Nevertheless, the extent of motion is limited to 30 external rotation, 90 flexion and abduction in a painfree range 29, 37. Postoperative rehabilitation after rotator cuff repair. Data suggest that the incidence of surgery to repair the rotator cuff is rising. Download rotator cuff rehabilitation therapist directed program book pdf free download link or read online here in pdf. The intent of this protocol is to provide the clinician with a guideline of the post.
Pdf epidemiology and demographics of the rotator cuff tear. It is not intended to be a substitute for ones clinical decision making. Rotator cuff repair omics internationalphysical medicine. General time frames are given for reference to the average, but individual patients will progress at. Then physician and patient work towards the strengthening of shoulder. Clinical outcomes of rotator cuff repair with arthroscopic. After an injury or surgery, an exercise conditioning program will help you return to daily. Arthroscopic or open rotator cuff repair rehabilitation protocol daniel redziniak, md the orthopedic and sports medicine center office. The team at the stone clinic has been repairing rotator cuffs for over twenty years and has progressively improved the techniques. Check information about shoulder injuries including the rot. Type of repair patients who have had deltoid muscle detachment or release from the acromion or clavicle e. Victoria bc v8z 0b9 tel 250 940 4444 fax 250 385 9600 page 1 june 2017 v1s.
On the other hand, 25% of all individuals over the age of 60 have a rotator cuff tear. If initial nonsurgical treatment of a rotator cuff tear fails, surgical repair is often the next line of treatment. Considerations for the total shoulder arthroplasty and hemiarthroplasty rehabilitation program many different factors influence the postoperative rehabilitation outcome, including surgical approach, concomitant repair of the rotator cuff, arthroplasty secondary to fracture, arthroplasty secondary to rheumatoid arthritis or. Rotator cuff repair rehabilitation garner rotator cuff. There are four tendons in the rotator cuff, and these tendons are attached individually to the following muscles.
Rehabilitation protocol for rotator cuff repair this protocol is intended to guide clinicians and patients through the postoperative course of a rotator cuff repair. Purpose of the abductor pillow is to keep tension off of the repair, avoid adduction. Pictures courtesy of simpleset, used with permission. Springer nature is making sarscov2 and covid19 research free. The criteria to progress from phase i to phase ii is a pain free passive motion. Rotator cuff repair the following is a protocol for postoperative patients following rotator cuff repair. The prevalence full thickness tears in the general population is about 20% and markedly increased after the age of 50.
Sling immobilization active rom elbow, wrist and hand passive only rom shoulder pendulums, supine elevation in scapular plane 140 degrees external rotation 40 degrees. However, there is no consensus concerning the rehabilitation protocol following surgery. We present an allarthroscopic surgical technique for the repair of an lshaped massive rotator cuff tear. There is evidence to suggest that the number of operations to repair the rotator cuff has risen over recent years. It would be great if the surgeon could give you an idea of the quality of the tissue and their preference for rehab, as mike suggested. Rehabilitation of the shoulder following rotator cuff. Procedures may vary depending on your condition and your healthcare providers practices. If you have significant pain or have had a sudden or acute rotator cuff tear, your surgeon may recommend surgery to repair the rotator cuff tear to reduce the pain in your shoulder. Specific interventions should be based on the needs of the individual and should. Your shoulder is the most mobile joint in your body and is therefore dependent on strong muscles to move and stabilise it. Inclusion criteria were patients undergoing arthroscopic rotator cuff repair. Exercise in the treatment of rotator cuff impingement. Previous studies have reported that approximately 25%. These will let him see which parts of your rotator cuff are damaged and how best to fix them.
A small size rotator cuff tear is defined as a tear rotator cuff repair is performed, either arthroscopically or via miniopen procedure, by suturing the torn tendon to the. Complete visualization of the tear pattern is paramount to creating an optimal repair. The ultrasling is to be worn for 6 weeks, following rotator cuff repair. Talk to your doctor or physical therapist about which exercises will best help you meet your rehabilitation goals. The goal of arthroscopic rotator cuff repair surgery is to make sure there is to clear up the area around the rotator cuff and locate and repair the torn end of the rotator cuff tendon back to the upper arm from where it was torn. Rehabilitation following rotator cuff repair begins with a close communication between the surgeon, the patient and. These videos should not be used as a substitute for regular physical therapy visits and guidance from your physician. This site is like a library, you could find million book here by. Rotator cuff repair is a common cause of shoulder pain, weakness, limitations to daily activity, and time off from work. Arthroscopic massive rotator cuff repair and techniques. Pdf download for early active rehabilitation after arthroscopic rotator cuff.
Rehabilitation protocol for rotator cuff repair massachusetts. Pdf rehabilitation after rotator cuff repair researchgate. It should be stressed that this is only a protocol and should not be a substitute for clinical decision making regarding a patients progression. The procedure involves stitching the torn tendon back onto its attachment to the humerus. Jan 09, 2016 postoperative shoulder rotator cuff repair rehabilitation protocol from san francisco orthopaedic sports medicine surgeon dr. Rotator cuff repair may be done on an outpatient basis or as part of your stay in a hospital. Rehabilitation, arthroscopic rotator cuff repair, shoulder, scientific rationale, rehabilitation protocols. But, while surgical technique has developed, rehabilitation, a critical component of the recovery process has not. Plymouth rotator cuff repair rehabilitation protocol phase 1. 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. Considerations for the postoperative rotator cuff repair rehabilitation program. The level i and ii evidence for rotator cuff repair rehabilitation is exceedingly small. Exercises and physical therapy for rotator cuff tear. Specific interventions should be based on the needs of the individual and should consider exam findings and clinical decision making.
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. Rotator cuff repair adopted 298, revised 704, revised 1108 1 general principles. Click here to download a pdf version of the rotator cuff repair rehabilitation guide. Rotator cuff repair is the surgery used to repair a tear in one of these tendons. This rehabilitation program has been distilled from seven level 1 or level 2 randomized controlled trials that demonstrate benefits from physical therapy for treating rotator cuff pain. Sean mcmillan book pdf free download link book now. All of the exercises should be performed with slow and controlled motion. Postoperative rotator cuff repair rehabilitation protocol. Early active rehabilitation after arthroscopic rotator cuff repair. A total of 27 patients who underwent rotator cuff repair were randomized to a rehabilitation group that used pulleys initiated 6 weeks postoperatively, and 26 patients followed a rehabilitation protocol without pulleys.
Sean mcmillan book pdf free download link or read online here in pdf. Rotator cuff repair may be done while you are asleep under general anesthesia, or while you are awake under local or regional anesthesia. Rotator cuff repair post operative rehabilitation protocol. 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 rehabilitation after rotator cuff surgery is carried out largely by the patient. The uncertainty regarding the cause of preoperative shoulder stiffness accompanying rotator cuff tears does not allow surgeons to establish whether and when a patient will recover from pain and disability after rotator cuff repair. Rotator cuff repair protocol boston shoulder institute. Disorders of the rotator cuff, including tears, are thought to be the most common cause of this shoulder pain. Plymouth rotator cuff repair rehabilitation protocol. Rehabilitation following rotator cuff repair springerlink. Rotator cuff tears are among the most common shoulder injuries and are usually accompanied by shoulder pain, disability, and dysfunction 1,2.
It is essential that he or she follow this rehabilitation program very closely. Surgery to repair a torn rotator cuff most often involves reattaching the tendon to the. Rotator cuff surgery and rehabilitation dr ivan popoff au. Despite this rise, the most effective approach to postoperative rehabilitation, a critical component of the recovery process, is not well developed. A large size rotator cuff tear is defined as a tear 35cm. Open access journals are freely available online throughout the world, for you to read, download, copy, distribute, and use. Remove sling for light activity and home exercise program as indicated by therapist.
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