Presentation Transcript

  1. University Orthopedics, Inc. ROTATOR CUFF REPAIR The following is a protocol for postoperative patients following rotator cuff repair. The primary goal of this protocol is to protect the repair while steadily progressing towards and ultimately achieving pre-injury level of activity. Please note this protocol is a guideline. Patients with additional surgery will progress at different rates. Achieving the criteria of each phase should be emphasized more than the approximate duration. If a patient should develop an increase in pain or swelling or decrease in motion at any time, activity should be decreased until problems are resolved. PHASE I: 1-21 DAYS POSTOPERATIVE GOALS: • Pain control • AAROM Flexion and Abduction to 90 degrees AMBULATION AND BRACE USE Immobilizer with abductor pillow x 4-6 weeks – Even while sleeping – Place pillow under shoulder / arm while sleeping for comfort EXERCISES: Hand squeezing exercises Elbow and wrist active motion (AROM) with shoulder in neutral position at side Supported pendulum exercises Shoulder shrugs / scapular retraction without resistance PROM by therapist / Active assist motion (AAROM) w/ pulleys or supine w/ wand – Flexion to 90 degrees – Abduction to 90 degrees – ER to within 30 degrees of opposite shoulder Stationary bike (must wear immobilizer) Ice pack PHASE II: ~3-6 WEEKS POSTOPERATIVE GOALS: • AAROM Flexion and Abduction to 150 degrees AMBULATION AND BRACE USE: Continue immobilizer x 4-6 weeks EXERCISES: Continue appropriate previous exercises Full pendulum exercises AAROM – Flexion and Abduction > 90 degrees (pulleys, supine wand) – ER as tolerated (wand, doorway stretch) – IR as tolerated if no subscapularis repair (wand behind back) 1-2 Finger Isometrics x 6 (fist in box PHASE III: ~4-8 WEEKS POSTOPERATIVE GOALS: • Full AROM AMBULATION AND BRACE USE: D/C Immobilizer EXERCISES: Continue appropriate previous exercises AROM, AAROM through full range Light Theraband ex x 6 Standing rows with Theraband Prone scapular retraction exercises (without weights) Biceps and Triceps PREs with light weight UBE forwards and backwards with low resistance Stairmaster Treadmill – Walking progression program Pool walking / running – No UE resistive exercises PHASE IV: ~9-12 WEEKS POSTOPERATIVE 1

  2. GOALS: GOALS: • • • Normal rotator cuff strength 30 wall push-ups Return to all activities EXERCISES: Continue appropriate previous exercises Weight training with light resistance (no overhead press or pull downs) Gravitron – Pull-ups and dips Push-ups, regular Sit-ups Swimming Running progression to track Transition to home / gym program No contact sports until 9 months post-op EXERCISES: Continue appropriate previous exercises PROM / mobilization as needed to regain full ROM Theraband ex with increased resistance as tolerated Seated row weight machine with light weight Body Blade Ball on wall (arcs, alphabet) BAPS on hands Ball toss with arm at side using light ball Push-up progression against wall Elliptical trainer Pool therapy – With UE resistance PHASE V:~3-4 MONTHS POSTOPERATIVE GOALS: • 30 chair push-ups • Run 2 miles at easy pace EXERCISES: Continue appropriate previous exercises Push-up progression – Table to chair Ball toss overhead Fitter on hands Treadmill – Running progression program PHASE VI:~4-6 MONTHS POSTOPERATIVE **This protocol is designed to be administered by a licensed physical therapist and/or certified athletic trainer. Please do not hesitate to contact our office should you have any questions concerning the rehabilitation process. 2