Pictures courtesy of simpleset, used with permission. Rotator cuff tendinopathy, ultimately leading to tear. Start against gravity and gradually progress with weights 2. A torn rotator cuff due to an injury is usually best treated by immediate surgical repair.
Rotator cuff rc disease is a frequent cause of shoulder pain and can result in weakness, alterations in glenohumeral kinematics, and shoulder instability in some circumstances. Rehabilitation guidelines for type i and type ii rotator cuff. The acute stage, immediately after injury, recovery stage, functional stage and returning to full fitness. This shoulder rehabilitation program focuses on strengthening the muscles that support your shoulder to help keep your shoulder joint stable, relieve pain and. 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 shoulder is immediately weak and there is pain when trying to lift the arm. The rotator cuff is an integral part of the anatomy of the shoulder. Degenerative rotator cuff tears also tend to coexist with poor muscle bulk muscle atrophy and fatty infiltration of the one or more rotator cuff muscles. Begin with 510 repetitions, advancing to 30 repetitions as able. This video is designed to help maximize your recovery following rotator cuff repairsurgery. Department of rehabilitation services physical therapy arthroscopic rotator cuff repair protocol. The socket portion of the joint is not naturally deep. Feb 24, 2017 exercises for rotator cuff stability and strengthening.
The best rotator cuff exercises and stretches medical news today. Take a break from activities or sports that may be aggravating your shoulder symptoms. These rotator cuff strengthening exercises will build strong, stable and mobile shoulders helping you stay active and painfree. Talk to your doctor or physical therapist about which exercises will best help you meet your rehabilitation goals. An injured rotator cuff is painful, frustrating, and, unfortunately, very common. Clinical practice guidelines for the management of rotator. No arom exercise of the shoulder consistent use of sling unless otherwise instructed weaning starting at week 4 at earliest pendulum exercises, elbow aarom and gripping 4x per day starting pod 3. When beginning a rehab program, short and long term goals are needed to keep the athlete progressing through the rehabilitation plan. Bulletproof your shoulders with 8 prehab rehab exercises. Rotator cuff repair protocol south shore orthopedics.
Of those, 100% started with scapular dyskinesis, a component of upper crossed syndrome. There are many factors that determine the speed of recovery. Erir at 0 degrees shoulder abduction, flexion and scaption thumb up to 90 degrees er in sidelying standing rows with theraband prone horizontal shoulder abductionscapular retraction at 90 degrees serratus anterior exercises. Maximise shoulder strength of deltoid, intact cuff muscles and scapula stabilisers. Rotator cuff repair rehab has changed dramatically in the past several years due to improved surgical techniques, emphasis on immediate motion, early strengthening and functional activities. Rotator cuff repair rehab northeast orthopedics and. Use a bag of crushed ice or frozen peas for 1520 minutes. How to do the exercises posterior stretching exercise 1. 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 rotator cuff strain rehabilitation program is based around four stages. Matthew boess rotator cuff repair rehabilitation video series. Rotator cuff repair postoperative rehabilitation protocol. Asps rotator cuff repair rehab protocol weeks 04 sling should be worn at rest. Avoid provocative maneuvers or exercises that cause discomfort o includes both offending rom exercises and strengthening exercises. Specific interventions should be based on the needs of the individual and should consider exam findings and clinical decision making. Your left forearm should be forward with your palm facing down. No supporting of body weight by hand on involved side. Conservative rotator cuff tear protocol sports and orthopedic. To ensure that this program is safe and effective for you, it should be performed under your doctors supervision. Your right arm should be extended overhead with your head resting on your arm.
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. Rotator cuff tearsurgery rehabilitation exercise program. Exercises you can do at home exercises are a very important part of treatment for a rotator cuff disorder. Rotator cuff rehab the physical therapy clinic, inc. 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 tears can be caused by degenerative changes, repetitive micro traumas, severe traumatic injuries, atraumatic injuries and secondary dysfunctions. The conservative rehabilitation protocol allows sharpey fibers to form before stressing the repair with resistive exercises. If you have a rotator cuff injury, the following treatment may be helpful. Pt is a way to get back strength and movement after an injury. Rom 1 codmanspendulum bend over chairtable, hang affected arm straight. Rotator cuff tears rotator cuff tears are associated with pain and dysfunction of the shoulder. Youre more likely to have this if you have a job where you need to move your arm a certain way over and over, like a.
The renowned shoulder orthopedist, dr charles neer, estimated that 95% of rotator cuff tears were from repetitive impingement sais rather than acute injury. Rehabilitation after rotator cuff repair the open orthopaedics journal, 2017, volume 11 155 outpatient procedure and mainly enables secure fixation and sequentially early return to motion 3, 4. Victoria bc v8z 0b9 tel 250 940 4444 fax 250 385 9600 page 1 june 2017 v1s. Rotator cuff rehab protocol thomas burns, md weeks 14 range of motion passive only home stretches pendulum exercises strength no rotator cuff contraction sling weeks 58 range of motion goal is full motion in all planes at end of 68 weeks continue home stretches strength active assisted rom, progressing to active rom. Rotator cuff sprain and strains university of california. Etiologies include acute injury or more commonly agerelated degenerative changes to the tendon that leads to partial and then full thickness tears. Pushouts hands and knees weight shifting, ball on wall weight shifting. Shoulder rotator cuff tear center for sports medicine. It is prone to injury, but doing specific exercises can help prevent this. Whether nonsurgical or surgical, successful management of rotator cuff disease is dependent on appropriate rehabilitation. Exercises here are some examples of typical rehabilitation exercises for your condition.
If pain, weakness, and stiffness in your shoulder see figure in appendix are related to problems with your rotator cuff, a doctor will usually first recommend nonsurgical treatment. Full tears are completely through the tendons similar to a buttonhole on a shirt creating a gaphole in the cuff. The conservative approach may be associated with postoperative stiffness which can be managed once healing has occurred. How to walk correctly and fix your lower back pain.
Rotator cuff tears can be classified in various ways. Kate hopman2, lee krahe1, sue lukersmith2, alexander mccoll1, kris vine1. Exercises and physical therapy for rotator cuff tear. Progress to isotonics when elevation against gravity 80 deg. Increase the use of the injured arm as directed by comfort.
Rehabilitation of rotator cuff injuries consists of four elements. Shoulder pain may be caused by inflammation or injury to the rotator cuff tendons resulting from trauma, overuse, weakness, poor posture, or a faulty movement. This process alone can lead to rotator cuff tears in older patients. Brace abduction bracesling, remove sling only to bathe and to complete exercises. Sling immobilization with supporting abduction pillow to be worn at all times except for showering and rehab under guidance of pt range of motion true passive range of motion only to patient tolerance. Your doctor or therapist will tell you when you can start these exercises and which ones will work best for you. Machines for exercising the rotator cuff muscles exist in the art for exercising the rotator cuff muscles of a user. Rotator cuff repair revised august 2008 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 supported pendulum exercises. Rotator cuff repair william beaumont army medical center. Rotator cuff and shoulder rehabilitation exercises.
My colleagues and i are questioning the use of isometrics when in the passive range of motion phase to strengthen the muscles in the newly gained range to avoid inflammation within the sarcomere. For this reason the shoulder is the most mobile joint in the body. For many people, physical therapy pt is the answer. Rotator cuff and shoulder rehabilitation exercises orthoinfo aaos.
A rotator cuff tear is often the result of wear and tear from daily use. Epidemiology of rotator cuff tears is difficult to assess based on the variance in symptoms. Maintenance and continuation of isotonic strengthening exercises should be encouraged 12xweek for 36 months. Where as, long term goals focus on return to play criteria and functional levels for the athlete to perform as needed. Rehabilitation protocol after arthroscopic rotator cuff 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. Rotator cuff repair protocol boston shoulder institute. Patients over 50 years of age are more susceptible to sustaining a significant rotator cuff tear from trauma. 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. All of the exercises should be performed with slow and controlled motion. The rotator cuff is a group of muscles and tendons, which hold the glenohumeral joint together and help lift the arm overhead, such as throwing a ball or swimming.
Jun 16, 2016 the rotator cuff muscles once again become deconditioned and the dynamic imbalance between the rotator cuff muscles and deltoidpectoralis muscles resumes, with the subsequent return of the impingement and symptoms. The image below is an mri sagittal plane of the rotator cuff. It may be all you need to treat an injured rotator cuff. 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. The rotator cuff can tear as an acute injury such as when lifting a heavy weight or falling on the shoulder or elbow. Check out the video tutorials plus my coaching notes and key points below each. With your left arm at your side, bend your elbow 90. Following a wellstructured conditioning program will also help you return to sports and other.
Conservative rotator cuff tear protocol sports and ortho. Postoperative rotator cuff repair rehabilitation protocol. Keep your left shoulder in place and raise your left arm. Bulletproof your shoulders with 8 prehabrehab exercises. Symptoms such as pain, swelling, or instability should be closely monitored by the patient. So common that rotator cuff issues sent 2 million people in the us to see a doctor in 20. Rotator cuff exercises rotator cuff surgery recovery. Rehabilitation guidelines for type i and type ii rotator. An evaluationbased approach abstract rotator cuff disease of the shoulder, a common condition, is often incapacitating.
Of critical importance is the type of surgery performed. It is no means intended to be a substitute for ones. Short term goals should be accomplished within a couple weeks. Rotator cuff and shoulder conditioning program orthoinfo aaos. May 01, 2017 lie on your right side on a table or bed.
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