Keep the abductor pillow in for the 4 weeks as well. The classification is based on the: (1) extent of the tear, (2) topography of the Phase II - Active Range of Motion Phase (starts approximately post op week 4) Goals: Minimize shoulder pain and inflammatory response Achieve gradual restoration of AROM Begin light waist level functional activities Wean out of sling by the end of the 2-3 postoperative week Return to light computer work MD follow-up visits at Day 1, Day 14 with nurse for suture removal, Month 1, Month 3, and Year 1 Post-op. SUBSCAPULARIS REPAIR REHABILITATION PROTOCOL ! Brace Abduction brace/sling, remove sling only to bathe and to complete exercises. Carpal Tunnel Release. Rotator Cuff Repair Lattissimus Dorsi Tendon Transfer: Quality Measures from Dr. Warner's Experience Scapulothoracic Winging: Our Experience . Restore muscular strength and balance. by the rotator cuff muscles, with assistance from the ligaments, glenoid labrum and capsule of the shoulder. A surgical repair is indicated when pain Latissimus dorsi tendon transfer protocol The intent of this protocol is to provide the physical therapist with a guideline/treatment protocol for the postoperative rehabilitation management for a patient who has undergone a latissimus dorsi tendon transfer (LDTT) for an irreparable rotator cuff tear. Arthroscopic Labral Repair Protocol-Type II, IV, and Complex Tears: PROTOCOL . Rotator Cuff Repair - Small to Medium Tear Rotator Cuff Repair - Large to Massive Tear SLAP I & III Protocol SLAP Repair - Type II Subacromial Decompression Protocol Total Shoulder Arthroplasty Protocol Upper Extremity Functional Assessment Elbow Distal Biceps Tendon Repair Protocol Lateral Epicondyle Debridement Protocol Download Contact Get Directions Request Appointment New patients please call toll-free. Patients who underwent rotator cuff repair and participated in the outcomes registry from July 2012 to June 2015 were screened based on inclusion and exclusion criteria. Arthroscopic Rotator Cuff Repair Protocol Arthroscopic Rotator Cuff Repair FAQs and Post-Operative Guidelines Biceps Tenodesis Protocol Biceps Tenotomy Protocol . When overused or injured, tendons in the rotator cuff can tear and may require surgery to repair. Online physiciandirectory.brighamandwomens.org Simon Gortz, MD. Protect the repair . If these conservative measures are insufficient, your doctor may recommend arthroscopic surgery During the surgery, your doctor will examine the labrum and the biceps tendon. Apply ice to the shoulder as tolerated to reduce pain and swelling. Younger individuals have shown to have done better.1 It has been reported that the older an individual is when they have a rotator cuff repair the likelihood of cuff healing diminishes.2 Increased . Maintain good upright shoulder girdle posture at all times and especially during sling use. COPYRIGHT*2014*CRC*"BRIAN*J. (70 Ratings, 12 Comments) About Our Process. Light active scapular strengthening . 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 tendons/muscles. GOALS: 1. Selection and management of a postoperative rotator cuff repair rehabilitation protocol is a vital component in achieving pain control in patients, a reliable . Strengthening. Breakdown of Rotator Cuff Tendon Repairs: 87 = Revision Cases (23%) 102 = Massive Tears (26%) 353 involved Supraspinatus Tendon (91%) The conservative rehabilitation protocol allows Sharpey fibers to form before stressing the repair with resistive exercises. The superiorly migrated humeral head indicates rotator cuff deficiency. o Advance kinesthetic awareness exercise to multi-angle and gradually work from short to long lever arm o CKC progression: quadruped, ball compression, wall push ups, knee push ups. 1 The annual cost of treating shoulder pain was $7 billion in the year 2000 in the United States. These muscles originate on the shoulder blade and attach to the humeral head. The rotator cuff is made up of muscles and tendons that hold the shoulder in place. Shoulder Motion. Candidates for Protocol Large to massive tear Poor Donohue sports physical and acl repair protocol brigham and bracing preventing a single surgery understanding surgery. 2. ROM Exercises; Maximise shoulder strength of deltoid, intact cuff muscles and scapula stabilisers. 2 Post-Op Debridement without Chondroplasty, Osteoplasty or Microfracture: Gait: WBAT with crutches-may advance off crutches if no pain and normal gait pattern Dressing: Removed at first PT visit, cleansed and band-aids applied Exercise Recommendations: Avoid supine straight leg raise, trunk curls with hip flex, She serves as the Chief of Women's Sports Medicine and her clinical interests are focused on preventing and providing care for sports injuries. ROTATOR CUFF REPAIR PROTOCOL ; Indiana 724.465.2676. REVISED: Special Note: This protocol is only a guideline and not intended to substitute for appropriate clinical . In this course Anthony Maritato, PT licensed physical therapist reviews some of the best post surgical rehabilitation protocols in the world. Clipping is a handy way to collect important slides you want to go back to later. Total Arthroscopic Rotator Cuff Repair Surgeries = 386. Passive Range of Motion: Pendulum exercises Active Range of Motion: Cervical, elbow, fingers and hand. Day 1 - 3 weeks. 1 Chung SW et al. 1 OF 4 . It's one of the most important parts of the shoulder. Rotator cuff strengthening with light Theraband - ER and IR with arm at side and pillow or towel roll under arm - Flexion to 60 degrees - Abduction to 60 degrees - Scaption to 60 degrees - Extension to 30 degrees Standing rows with Theraband Prone scapular retraction exercises (with light weight) Ball on wall (arcs, alphabet) You will be instructed by your surgeon to wear your sling from four to six weeks depending upon the size of your tear and thus the extent of the rotator cuff repair, and the sling should be worn at all times. quantify the prevalence of mood disorders in patients undergoing arthroscopic rotator cuff repair using a large claims database and 2) compare opioid use and medical costs . J Shoulder Elbow Surg. Mumford procedure rehab protocol. The given time frames PAGE . Phone: 617-983-7271 Brigham and Women's Faulkner Hospital Rehabilitation Services 1153 Centre Street, 2nd Floor Boston, MA 02130. However, areas of the surface did not change as dramatically, demonstrating some degree of disorganization. Elbow/wrist/hand AROM w/ no resistance. The majority of patients with subacromial im-pingement can be successfully managed with Biceps Tenodesis. DECELERATED ROTATOR CUFF REPAIR PROTOCOL Dr. David R. Guelich This rehabilitation protocol has been developed for the patient following a large to massiverotator cuff surgical procedure. Begin gentle isotonic and rhythmic stabilization techniques for rotator cuff musculature strengthening (open and closed chain) Continue cryotherapy as necessary Follow Dr. Gill's instructions regarding moving your shoulder after surgery. If you have questions, contact the referring physician. Monday through Friday. It is by no means intended to be Rehabilitation protocols. Subpopulations protocol for an OA Trial Bank systematic review and. An injury to the rotator cuff, such as a tear, may happen suddenly when falling on an outstretched hand or develop over time due to repetitive activities. See what the surgical team from Brigham and Women's Hospital (A teaching affiliate of Harvard Medical School) recommends following a rotator cuff repair surgery. It MOON Shoulder Post-operative Rotator Cuff Repair Protocol - Therapist Instructions 2 Passive Motion (0-4 weeks) Passive range of motion begins within 7 days after surgery. Rotator cuff strengthening in at 90 abduction, and overhead. Phase I: Days 1 to 28 Days 1 to 6 . Rotator cuff tears are increasing in frequency in the aging population and are a common issue seen by orthopaedic surgeons.1 In patients with large, multi-tendon rotator cuff tears or retears, treatment can be challenging. She serves as the Chief of Women's Sports Medicine and her clinical interests are focused on preventing and providing care for sports injuries. Specific interventions should be based on the needs of the individual and should consider exam findings and clinical decision making. She performs minimally invasive arthroscopic knee and shoulder surgery including ACL reconstruction . Rotator Cuff Repair Post-operative Rehabilitation Protocol. o Begin light isometrics with arm at the side for rotator cuff and deltoid o Advance to therabands as tolerated o Passive stretching at end range of motion to maintain shoulder flexibility Modalities per PT discretion Phase III (Weeks 8-12) Range of Motion - Progress to full AROM without discomfort The conservative approach may be associated with post-operative stiffness which can be managed once healing has occurred. Rotator Cuff Repair. The rotator cuff is a group of muscles and tendons that stabilize the shoulder joint, enabling the shoulder in move in different directions. DEVELOPED: 4/2008 . ROTATOR CUFF REPAIR . Passive range of motion requires the therapist or an assistant at home to put the arm through a comfortable range of motion while the patient is supine. The prosthesis has 5 parts: the glenoid base, the glenosphere, a polyethylene cup, humeral neck, and the humeral Figure 3. If you need to continue to complete range of this information about an athymic rat rotator cuff and your experiences may begin musculature, wrist and massive rotator cuff repair protocol brigham and. Scapular strengthening and dynamic neuromuscular control in OKC and CKC positions CKC should be cautious starting at 12 weeks with hands and knees only. Precautions No lifting or activities that cause pain. 1 OF 4 . Rotator Cuff Repair Post-Operative Protocol Jason Dieterle, DO Supraspinatus = small tear Supra + Infraspinatus = large tear 0-2 WEEKS POST - OP: Wear sling until 4 weeks post op unless specified. Throwing a baseball can create up The deltoid muscle is separated to expose the torn . No supporting of body weight by hands and arms. Rehabilitation Protocol for Rotator Cuff Repair-Small to Medium Sized Tears This protocol is intended to guide clinicians and patients through the post-operative course of a rotator cuff repair. Hinged elbow braced applied at 30-100 available elbow ROM. PROM shoulder flexion/abduction/ER/IR. 250 South Main St. Suite 224A Blacksburg, VA 24060 540-552-7133 All information contained in this protocol is to be used as general guidelines only. Protect Surgical Repair 3. Figure 1. 7 April . Orthopaedic Surgery. Posterior splint applied in operating room at 90 elbow flexion and neutral forearm. The rotator cuff is a group of four muscles: subscapularis, supraspinatus, infraspinatus and teres minor (Figure 1). Open in a separate window. Non-Operative Rotator Cuff Tear Protocol Acute/early phase (limited, painful AROM, painful resisted testing) Sub-acute/mid phase . Reverse Total Shoulder Arthroplasty Components. Pre-op. 2). INTRODUCTION. Rotator cuff repair protocols Small; Medium-large; Massive ROTATOR CUFF REPAIR Most rotator cuff tears can be repaired surgically by reattaching the torn tendon(s) to the humerus. Brigham and Women's Faulkner Hospital Rehabilitation Services 1153 Centre Street - 2nd Floor Boston, MA 02130 617-983-7271 General Information Arthroscopic Rotator Cuff Repair is performed when there is a tear of one or more of the four muscles that comprise the Rotator Cuff. Elizabeth Matzkin, MD, is Board Certified and fellowship trained Orthopaedic Surgeon specializing in Sports Medicine at Brigham and Women's Hospital. The course is much slower postoperatively with more precaution to protect the repair. Figure 2. Total Number of Arthroscopic Rotator Cuff repair surgeries performed by Dr. Laurence D. Higgins at Brigham and WomensHospital = 200. Time from tear to repair; Patient variables such as age, arm dominance, pre-injury level, desired level of function, work situation, patient compliance to program; Physician's philosophical approach (Wilk et al, 2000) Protocols.