The rotator cuff can also wear out as a result of degenerative changes. Shawn hennigan, md rotator cuff repair rehabilitation protocol the following document is an evidencebased protocol for arthroscopic rotator cuff repair rehabilitation. Prior to rotator cuff repair surgery for rotator cuff tear, you are advised to visit your physiotherapist to make sure you are ready for your postop rehab. Paff, do orthopaedic surgeon upper extremity specialist 370 n 120th ave holland, mi 49424 p 616. Rotator cuff surgical repair return to sport 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. Small tear 23 weeks educate that patient should continue to avoid active shoulder motion even when out of the sling until allowable by protocol. 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 this rehabilitation protocol has been developed for the patient following a rotator cuff surgical procedure. Rotator cuff repair protocol rotator cuff repair protocol this rehabilitation protocol has been developed for the patient following a rotator cuff surgical procedure. Suite 224a blacksburg, va 24060 54055273 all information contained in this protocol is to be used as general guidelines only.
Protocol s3 accelerated physical therapy protocol for rotator cuff repair arthroscopic or miniopen technique recommended for mild. Type two rotator cuff repair arthroscopic or miniopen medium to large tear greater than 1 cm and less than 5 cm i. Rotator cuff repair protocol south shore orthopedics. Protocol s3 accelerated physical therapy protocol for rotator. Type ii rotator cuff repair protocol medical staff.
This protocol will vary in length and aggressiveness depending on factors such as. 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. 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. Help and feedback was given from people who have had rotator cuff repair surgery. Keep the abductor pillow in for the 4 weeks as well. Rotator cuff repair therapy protocol sideline orthopedics. This rehabilitation protocol has been developed for the patient following a rotator cuff surgical procedure.
Arthroscopic rotator cuff repair protocol small to medium sized tears david j. Type three rotator cuff repair miniopen or neer approach large to massive tear greater than 5 cm i. Brace abduction bracesling, remove sling only to bathe and to complete exercises. 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. No arom exercise of the shoulder consistent use of sling unless otherwise instructed weaning starting at week 4.
This protocol is intended to guide clinicians and patients through the post operative course of a rotator cuff repair. For this reason the shoulder is the most mobile joint in the body. Talk to your doctor or physical therapist about which exercises will best help you meet your rehabilitation goals. If you have any questions regarding the progress of the patient, the physician should be. Rehabilitation guidelines for type i and type ii rotator cuff.
Rotator cuff repair rehab protocol the stone clinic. A torn rotator cuff due to an injury is usually best treated by immediate surgical repair. Rotator cuff repair therapy protocol page 1 of 6 bart eastwood d. 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. 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 protocol rotator cuff protocol. Arthroscopic rotator cuff repair protocol brigham and womens. Sling immobilization with supporting abduction pillow to be worn at all times except for showering and rehab under guidance of pt. The protective protocol, in which muscle strengthening exercises are delayed, is applied after arthroscopic repair of rotator cuff tears greater than 5 cm or involving more than 2 tendons, poor tissue quality, or repairs with greater tension.
Rotator cuff repair protocol is a rehabilitation protocol to provide patient with the guidelines following a rotator cuff surgical procedure. Size and location of tear degree of shoulder instabilitylaxity prior to surgery acute versus chronic condition. 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. Contact dr kevin murphy at 9046340640 to know more. Rotator cuff and shoulder conditioning program orthoinfo aaos. 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. The procedure involves stitching the torn tendon back onto its attachment to the humerus. Rotator cuff repair protocol northeast orthopedics and.
Rotator cuff repair protocol rotator cuff protocol physical. Shoulder rotator cuff repair oxford university hospitals. Remove sling for light activity and home exercise program as indicated by therapist. Showering is allowed once dressings and catheter is removed. This protocol is intended to guide clinicians and patients through the postoperative course of a rotator cuff repair. 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. This may be performed arthroscopically or through open surgery, using sutures and bone anchors. The intent of this protocol is to provide the clinician with a.
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. This is because the articular surface of the round humeral head is approximately four times greater than that of the. The shoulder is a wonderfully complex joint that is made up of the ball and socket connection. Arthroscopic rotator cuff repair protocol medium to large. Size and location of tear degree of shoulder instabilitylaxity prior to surgery. Type ii rotator cuff repair protocol arthroscopic tears for large to massive tears 5 cm joseph r. Specific interventions should be based on the needs of the individual and should consider exam findings and clinical decision making. The socket portion of the joint is not naturally deep.
Tear size largemassive tear or 1 tendon repair difficult to achieve full rom, caution with arom and resisted exercises with chroniclarge tears. No arom exercise of the shoulder consistent use of sling unless otherwise instructed weaning starting at week 4 at earliest. Specific changes in the program will be made by the physician as appropriate for an individual patient. Rotator cuff repair protocol shoreline orthopaedics. Purpose of the abductor pillow is to keep tension off of the repair, avoid adduction.
Strengthen deltoid, rotator cuff and scapular stabilizers. Most rotator cuff tears can be repaired surgically by reattaching the torn tendons to the humerus. 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. Abduction bracesling, remove sling only to bathe and to complete exercises. Rehabilitation guidelines for type i and type ii rotator. 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 boston shoulder institute. Murphy, md board certified orthopedic surgeon specializing in sports medicine and arthroscopy 10475 centurion pkwy. 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. Conservative rotator cuff repair protocol this protocol is designed to serve as a patient rehabilitation guide following a massive or fragile rotator cuff repair procedure. The conservative rehabilitation protocol allows sharpey fibers to form before stressing the repair with resistive exercises. The conservative approach may be associated with postoperative stiffness which can be managed once healing has occurred. Phase i immediate postoperative phase weeks 0 6 days 014 patient is seen 2 days postoperative to remove surgical dressings and pain catheter.
Maximise shoulder strength of deltoid, intact cuff muscles and scapula stabilisers. Rotator cuff repair rehab protocol in the early 1990s, dr. Rotator cuff repair post operative rehabilitation protocol. Rotator cuff repair postoperative rehabilitation protocol. Massive rotator cuff repair protocol sports and ortho. It is not intended to be a substitute for clinical decision. Size and location of tear degree of shoulder instabilitylaxity prior to surgery acute versus. Shawn hennigan, md rotator cuff repair rehabilitation protocol. 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.
Now that your rotator cuff tear has been repaired it is very important that you follow this rehabilitation protocol in order to optimize your results. Sports medicinearthroscopic surgery the intent of this protocol is to provide the therapist and patient with guidelines for the postoperative rehabilitation course after arthroscopic rotator cuff repair. It is no means intended to be a substitute for ones. Rotator cuff repair postoperative rehabilitation protocol orthoindy.