Evaluating strategies and outcomes following rotator cuff tears. Rotator cuff repair surgery can now be performed arthroscopically and is in most cases an. 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. Incidence 540% with increasing with advancing age 40 years. The safest resting position after rotator cuff repair is 30 of elevation in the scapular plane, with 0 to 60 of external rotation which can be attained with the abduction sling.
The procedure involves stitching the torn tendon back onto its attachment to the humerus. Protocol s3 accelerated physical therapy protocol for rotator cuff repair. Rehabilitation protocol for rotator cuff repair this protocol is intended to guide clinicians and patients through the postoperative course of a rotator cuff repair. Rehabilitation protocol after arthroscopic rotator cuff repair. Rehabilitation protocols, surgical fixation techniques, biologic therapy. Phase i immediate postoperative phase weeks 0 6 days 014 patient is seen 2 days postoperative to remove surgical dressings and pain catheter. Repair of rotator cuff tears uw orthopaedics and sports. 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. Rotator cuff repair of protocol page3 phase 1 immediate post operative this phase involves the initial recovery period after surgery and generally lasts until 46 weeks post operative. Routine early rotator cuff repair general instructions for therapists.
A torn rotator cuff due to an injury is usually best treated by immediate surgical repair. 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 rotator cuff repair massachusetts. Contact dr kevin murphy at 9046340640 to know more. The conservative approach may be associated with postoperative stiffness which can be managed once healing has occurred. This protocol provides you with general guidelines for the conservative rehabilitation of the patient with a rotator cuff tear rct. Among a growing discussion surrounding the superiority of one surgical technique over another, the surgeons ability to complete a rotator cuff repair with technical acuity in a timely manner remains paramount. Rehabilitation guidelines for type i and type ii rotator cuff. 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. Therapy is to being 2 weeks after the surgery for this protocol. Among most common causes of shoulder pain and instability. This protocol provides you with general guidelines for the rehabilitation of patients following a massive open andor arthroscopic rotator cuff repair. Rotator cuff repair protocol is a rehabilitation protocol to provide patient with the guidelines following a rotator cuff surgical procedure. The socket portion of the joint is not naturally deep.
Johns hopkins shoulder surgery arthroscopic acromioplasty rehabilitation program johns hopkins shoulder surgeons introduction. Appropriate communication between the therapist, patient and surgeon is key to a. Massive rotator cuff repair protocol sports and ortho. The rotator cuff can also wear out as a result of degenerative changes. Sling x 6 weeks ultrasling x 46 weeks, larger tears may be in ultrasling x 6 weeks then. Click here to download pdf shoulder torn rotator cuff. Surgery to repair a torn rotator cuff most often involves reattaching the tendon to the head of humerus upper arm bone. These principles are the cornerstone behind the protocol you are about to download. Type ii rotator cuff repair protocol medical staff.
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 may be performed arthroscopically or through open surgery, using sutures and bone anchors. Comparison of aggressive and traditional postoperative rehabilitation protocol after rotator cuff repair. Rotator cuff repair protocol page 3 of 3 14 weeks post op begin light tennis ball tossing at 2030ft. The success of surgery to repair the rotator cuff depends upon the size of the tear and how long ago the tear occurred usually, a small tear has a good chance for full recovery. Rotator cuff repair protocol boston sports medicine. Following a wellstructured conditioning program will also help you return to sports and other. Rotator cuff repair therapy protocol page 1 of 6 bart eastwood d.
It is no means intended to be a substitute for ones. Rotator cuff repair protocol northwestern medical center. Suite 224a blacksburg, va 24060 54055273 all information contained in. Pdf 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. This article contains details about these and other surgical treatments commonly used for rotator cuff tears. Small tear 23 weeks educate that patient should continue to avoid active shoulder. Remove sling for light activity and home exercise program as indicated by therapist.
Rotator cuff repair protocol northeast orthopedics and sports. 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. A tear is suspected in one of your rotator cuff tendons, either from examination or. Rotator cuff repair a rotator cuff repair is designed to improve pain and function in cases of rotator cuff tears. Arthroscopic rotator cuff repair protocol medium to large. Prom as instructed restrictionsexercise progression. Progress as tolerated open chain, closed chain, functional exercises.
The shoulder joint is a ball and socket joint that connects the. This protocol will vary in length and aggressiveness depending on factors such as. Rotator cuff repair protocol rotator cuff protocol physical. This is because the articular surface of the round humeral head is approximately four times greater than that of the. The physician will make specific changes to the program as appropriate for an individual patient. Manual laborers will likely be out of work for at least six months. Rotator cuff repair depends on both the fixation strength of the chosen repair construct and the local healing response of the repaired tissue. Rehabilitation guidelines for type i and type ii rotator. No arom exercise of the shoulder consistent use of sling unless otherwise instructed weaning starting at week 4 at earliest. Numerous rehabilitation protocols for the management of rotator cuff disease are based primarily on clinical experience and expert. Open, miniopen, and allarthroscopic rotator cuff repair. Strengthen deltoid, rotator cuff and scapular stabilizers. Routine early rotator cuff repair massive delayed rotator cuff repair.
Introduction in 1834, smith first description of a rupture of the rotator cuff tendon. Plymouth rotator cuff repair rehabilitation protocol phase 1. Introductionrotator cuff tear surgical repair techniques have significantly progressed. Rotator cuff repair protocol the following procedures were performed. 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 and shoulder rehabilitation exercises. The rotator cuff tendon needs to heal back into the bone rom goals. Rotator cuff and shoulder conditioning program orthoinfo aaos. Rotator cuff repair protocol boston shoulder institute. Type three rotator cuff repair miniopen or neer approach large to massive tear greater than 5 cm i. If the tear is large, the extent of recovery cannot be accurately predicted until. Type two rotator cuff repair arthroscopic or miniopen medium to large tear greater than 1 cm and less than 5 cm i. 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.
Even though miniopen rotator cuff repair is still commonly performed, and results are comparable to arthroscopic repair, allarthroscopic repair. Protocol s3 accelerated physical therapy protocol for rotator cuff repair arthroscopic or miniopen technique recommended for mild. No arom exercise of the shoulder consistent use of sling unless otherwise instructed weaning starting at week 4. Murphy, md board certified orthopedic surgeon specializing in sports medicine and arthroscopy 10475 centurion pkwy. Rotator cuff repair protocol rotator cuff protocol. It is not intended to be a substitute for clinical decision. If biceps tenodesis was performed no biceps strengthening until 8 weeks postop frequency.
Size and location of tear degree of shoulder instabilitylaxity prior to surgery acute versus chronic condition. Goals of rehabilitation following rotator cuff repair. Rehabilitation protocol following arthroscopic rotator cuff repair. If you have any questions regarding the progress of the patient, the physician should be. Pdf rehabilitation after rotator cuff repair researchgate. Treatment should be modified based on the condition of the rotator cuff. Protocol s3 accelerated physical therapy protocol for. Specific interventions should be based on the needs of the individual and should consider exam findings and clinical decision making. Rotator cuff repair protocol northeast orthopedics and. Rotator cuff repair therapy protocol sideline orthopedics.
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. Rotator cuff repair protocol south shore orthopedics. Rotator cuff repair protocol this rehabilitation protocol has been developed for the patient following a rotator cuff surgical procedure. Rotator cuff repair rehab protocol the stone clinic. Plymouth rotator cuff repair rehabilitation protocol. Click on your rehabilitation protocol to download a pdf file containing specific. Rotator cuff repair protocol rotator cuff repair protocol this rehabilitation protocol has been developed for the patient following a rotator cuff surgical procedure. It should be stressed that this is only a protocol and. It is not intended to be a substitute for clinical decision making regarding the progression of a patients postoperative course based. Throwing initially limit flexion to 90 degrees and then progress. Rotator cuff repair denver rotator cuff tears aurora denver. This protocol is intended to guide clinicians and patients through the postoperative course of a rotator cuff repair. The goal of rotator cuff repair is to eliminate pain and improve function with increased shoulder strength and range of motion. Johns hopkins shoulder surgery arthroscopic acromioplasty.
Size and location of tear degree of shoulder instabilitylaxity prior to surgery. Protocol s3 accelerated physical therapy protocol for rotator. Showering is allowed once dressings and catheter is removed. The team at the stone clinic has been repairing rotator cuffs for over twenty years and has progressively improved the techniques.
Size and location of tear degree of shoulder instabilitylaxity prior to surgery acute versus. 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 therapist and patient with guidelines for the postoperative rehabilitation course after arthroscopic rotator cuff repair. The patient should work with their therapist x per week until released by the surgeon. Rotator cuff repair denver rotator cuff tears aurora. Hearon operative shoulder protocols advanced orthopedic. Type ii rotator cuff repair protocol arthroscopic tears for large to massive tears 5 cm joseph r. This is summary of the evaluation and rehabilitation of a patient following an arthroscopic acromioplasty. Suite 224a blacksburg, va 24060 54055273 all information contained in this protocol is to be used as general guidelines only. Talk to your doctor or physical therapist about which exercises will best help you meet your rehabilitation goals. Abd max 6080 without rotation no resisted motions of shoulder until 12 weeks postop grip strengthening no canespulleys until 6 weeks postop, because these are activeassist exercises.
For this reason the shoulder is the most mobile joint in the body. Specific changes in the program will be made by the physician as appropriate for an individual patient. Rehabilitation, arthroscopic rotator cuff repair, shoulder, scientific rationale, rehabilitation protocols, tendon healing. This rehabilitation protocol has been developed for the patient following a rotator cuff surgical procedure. 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. A partial tear, however, may need only a trimming or smoothing procedure called a debridement. Rotator cuff repair with biceps releasetenodesis brian bjerke, md postoperative protocol phase i maximum protection week 0 to 6 goals. The intent of this protocol is to provide the clinician with a. 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. Surgery for shoulders with torn rotator cuff tendons can lessen shoulder pain and improve function without acromioplasty download this article as a pdf. Alaia, md assistant professor of orthopaedics division of sports medicine tel.