The physician will make specific changes to the program as appropriate for an individual patient. South shore hospital orthopedic, spine and sports therapy in clinical collaboration with south shore orthopedics page 1. Rotator cuff physical therapy guidelines and protocol. Rehabilitation guidelines for type i and type ii rotator. Can physical therapy help repair a rotator cuff tear. Rehabilitation protocol for reverse shoulder arthroplasty.
Rotator cuff physical therapy guidelines and protocol general guidelines. For many people, physical therapy pt is the answer. Physical therapy standards of care and protocol the following standards of care and protocols are the property of bwh and should not be copied or otherwise used without the permission of the director of rehabilitation services. The rotator cuff is made up of four muscles supraspinatus, infraspinatus, subscapularis, and teres minor and their tendons. Rotator cuff repair physical therapy protocol preoperative guidelines restore arom strengthen involved extremity in pain free rom, emphasize rotator cuffscapular stabilization musculature instruct in use of abduction pillow immobilizer, icing, hand gripping, elbow rom educate patient on postop protocol and importance of compliance for good. Move the arm by rocking the body forwardback, side to side, or in a circle. This protocol is designed for the patient following arthroscopic rotator cuff repair. Brace abduction bracesling, remove sling only to bathe and to complete exercises. Rotator cuff sprain and strains university of california.
A large size rotator cuff tear is defined as a tear 35cm, massive 5cm. There will always be individual differences amongst patients regarding progression and tolerance of specific activities. Jazrawi, md associateprofessoroforthopaedics chief2divisionofsportsmedicine tel. The first classification is a partial thickness or. This study performed a prospective, randomized evaluation of patient outcomes and rotator cuff healing after arthroscopic rotator cuff repair using a postoperative physical therapy protocol with early passive motion compared with a delayed protocol that limits early passive motion. At that time, they will help you schedule a physical therapy appointment at utsw. Abduction bracesling, remove sling only to bathe and to complete exercises. Physical therapy prescription arthroscopic rotator cuff. If you have any questions regarding the progress of the patient, the physician should be. However, the rotator cuff tear size, muscle atrophy, and fatty infiltration may progress. 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.
Arthroscopic rotator cuff repair small tear rehab protocol craig l. To ensure that this program is safe and effective for you, it should be performed under your doctors supervision. Specific interventions should be based on the needs of the individual and should consider exam findings and clinical decision making. Arthroscopic rotator cuff repair protocol medium to large. The rotator cuff tendon needs to heal back into the bone rom goals. Most rotator cuff tears can be repaired surgically by reattaching the torn tendons to the humerus. The physiotherapist must exercise their best professional judgment to determine how to. Jan 31, 2020 the goal of treating a rotator cuff tear is not necessarily to heal the torn tendon. Interval throwing program for little league age athletes. Dec 10, 2017 rotator cuff physical therapy varies depending on the stage of injury and whether you have had surgery to repair the shoulder. Rotator cuff repair protocol is a rehabilitation protocol to provide patient with the guidelines following a rotator cuff surgical procedure.
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. 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. The goal of treating a rotator cuff tear is not necessarily to heal the torn tendon. People can often achieve pain relief and improved strength by relieving inflammation and restoring shoulder joint mechanics.
Specific interventions should be based on the needs of the individual and should consider exam. Rotator cuff and shoulder rehabilitation exercises. Performs all exercises demonstrating symmetric scapular mechanics. 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. However, the rotator cuff tear size, muscle atrophy, and fatty infiltration may progress over 5 to 10 years with non operative management. Patients over 50 years of age are more susceptible to sustaining a significant rotator cuff tear from trauma. It is no means intended to be a substitute for ones.
This protocol provides you with general guidelines for the rehabilitation of patients following a massive open andor arthroscopic rotator cuff repair. Should you wish to perform therapy elsewhere, you should make arrangements to start therapy days following this visit. Rotator cuff tears can be classified in various ways. Large rotator cuff repair protocol fowler kennedy sport. Application of ice and tens for pain control at end of therapy session and at frequency of 4x day at home. Specific changes in the program will be made by the physician as appropriate for an individual patient. Prone scapular retraction exercises without weights.
Rotator cuff and shoulder rehabilitation exercises pdf handout. Arthroscopic rotator cuff repair frequently asked questions. Physical therapy prescription arthroscopic rotator cuff repair moon multicenter orthopaedic outcomes network immediate red protocol. Clv pt arthroscopic rotator cuff repair small rehab protocol. Rehabilitation protocol for rotator cuff repair massachusetts. It provides stability and strength for the shoulder joint, anchoring the humerus upper arm bone to the scapula shoulder blade so that movements of the arm can occur in a.
Pt is a way to get back strength and movement after an injury. Rotator cuff repair therapy protocol page 1 of 6 bart eastwood d. Start against gravity and gradually progress with weights. Physical therapy arthroscopic rotator cuff repair protocol. The intent of this protocol is to provide guidelines for your patients therapy progression. Reduce pain and inflammation maximize romflexibility of glenohumeral and scapulothoracic joints maximize strengthendurance of rotator cuff and scapular musculature educate client in short term use of sling for protection and activerest if necessary.
This handout serves as a guideline for your rehabilitation after rotator cuff repair. The intent of this protocol is to provide the patient, clinician and physical therapist with a guideline of the postoperative rehabilitation course of a patient that has undergone an. Clinic appointments at 8 to 12 days, then at 6 weeks, 12 weeks, 18 weeks and possibly 24 weeks postop physical therapy appointment starting at 2 weeks, lasting 12 to 18 weeks acute phase. Surgery may be required to treat shoulder tendinitis and bursitis if it becomes chronic or if there is a tear of the rotator cuff. Rotator cuff repair therapy protocol sideline orthopedics. Immediate postop phase first 57 days after surgery, prior to starting pt goals.
Specific variations may be appropriate for each patient and may be specified by the physician. Standard rotator cuff repair physical therapy philosophy this protocol is to be utilized as a guideline. Prospective randomized study of arthroscopic rotator cuff repair using an early versus delayed postoperative physical therapy protocol. 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 and shoulder rehabilitation exercises to ensure that this program is safe and effective for you, it should be performed under your doctors supervision. This is because the articular surface of the round humeral head is approximately four times greater than that of the.
Strengthening all exercises painfree rom only 3xweek max. Progression through the protocol will depend on successful accomplishments of set milestones as assessed by the. 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. The rotator cuff is responsible for stabilization and active movement of the glenohumeral joint. Those patients with poor rotator cuff tissue integrity, tear of 2. Your doctor may send you to a physical therapist for exercises or other therapy. Contact dr kevin murphy at 9046340640 to know more.
Rotator cuff and shoulder conditioning program orthoinfo aaos. 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. Exercises to strengthen the shoulder may help to prevent a recurrence. Initiating rotator cuff and scapula stabilization strengthening exercises should be. Considerations for the postoperative rotator cuff repair rehabilitation program. The intent of this protocol is to provide the clinician with a.
A referral for physical therapy is usually provided by a shoulder specialist, but your family physician may write a script to pt prior to sending you for further tests to confirm a rotator cuff tear. The deltoid muscle is separated to expose the torn. Early passive range of motion of the glenohumeral joint to prevent capsular adhesions is essential. Physical therapy standards of care brigham and womens. At this point you should begin your formal physical therapy, the instructions that follow are to aid your. Passive range of motion shoulde r fle xi onsc a pt i on 070 degree s, e xt e rnal rot a t i on to 30 degre e s. Rotation medical patch rehabilitation protocol phase i. Conservative rotator cuff tear protocol sports and orthopedic.
Suite 224a blacksburg, va 24060 54055273 all information contained in this protocol is to be used as general guidelines only. Rotator cuff tendonitisimpingement rehabilitation protocol. Rotator cuff repair protocol boston shoulder institute. This process alone can lead to rotator cuff tears in older patients.
It may be all you need to treat an injured rotator cuff. 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. Begin the second phase of rehabilitation with these strengthening exercises once you have. Those patients who have good rotator cuff tissue integrity, a one to two tendon repair, with a tear 3 centimeters or less will typically be progressed on the quicker end of these time frames. Rotator cuff postoperative rehabilitation protocol general considerations. Shoulder tendonitis center for sports medicine and.
Rotator cuff repair postoperative rehabilitation protocol orthoindy. This can be accomplished with physical therapy and antiinflammatory treatments, including medications, cortisone injections, and ice. Rotator cuff repair protocol rotator cuff protocol physical. Rehabilitation protocol for reverse shoulder arthroplasty this protocol is intended to guide clinicians and patients through the postoperative course after a reverse shoulder arthroplasty. Rotator cuff physical therapy varies depending on the stage of injury and whether you have had surgery to repair the shoulder. Rehabilitation guidelines for type i and type ii rotator cuff. This study evaluated patient outcomes and rotator cuff healing after arthroscopic rotator cuff repair using a postoperative physical therapy protocol with early passive motion compared with a. No arom exercise of the shoulder consistent use of sling unless otherwise instructed weaning starting at week 4 at earliest. Avoid provocative maneuvers or exercises that cause discomfort o includes both offending rom exercises and strengthening exercises. Orthopaedic surgery, sports medicine and rehabilitation rotator cuff re pai r postoperative physical therapy protocol exercise. Exercises and physical therapy for rotator cuff tear.