Rotator cuff and shoulder conditioning program stretching exercises 1. Move the arm by rocking the body forwardback, side to side, or in a circle. Most rotator cuff tears can be repaired surgically by reattaching the torn tendons to the humerus. To ensure that this program is safe and effective for you, it should be performed under your doctors supervision. The rotator cuff is made up of muscles and tendons that support the shoulder joint. Rotator cuff and shoulder rehabilitation exercises orthoinfo aaos. A rotator cuff tear is a common injury, especially in sports like baseball or tennis, or in jobs like painting or cleaning windows. Rotator cuff repair protocol boston shoulder institute. Rehabilitation protocol for small to moderate rotator cuff tear. 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. Deltoids, supraspinatus, infraspinatus, subscapularis equipment needed. Arthroscopic rotator cuff repair small tear rehab protocol craig l. Following a wellstructured conditioning program will also help you return to sports and other.
Shoulder injuries are very common in the collegeaged population. Rotator cuff sprain and strains university of california. Treatment involves a combination of modalities including. Rotator cuff tear is a common cause of shoulder disability and results in patients predominantly. Use a bag of crushed ice or frozen peas for 1520 minutes. The joint is a ball joint formed by the head of the humerus arm bone fitting into the socket of the scapula shoulder blade. Postoperative rotator cuff repair rehabilitation protocol. Summary table post op phasegoals range of motion therapeutic exercise precautions days 1 7 wear sling during the day and at night remove sling for showeringbathing remove sling 4 to 5 times per day for gentle elbow, forearm, wrist and finger exercises. The tendons of four muscles in the upper arm form the rotator cuff, blending together to help stabilize the shoulder.
Rotator cuff repair large to massive 5cm rehabilitation guideline this rehabilitation program is designed to return the individual to their activities as quickly and safely as possible. Famous physical therapists bob schrupp and brad heineck demonstrate the 10 best rotator cuff exercises for strengthening your shoulder. However, the rotator cuff tear size, muscle atrophy, and fatty infiltration may progress over 5 to 10 years with non operative management. 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. Start against gravity and gradually progress with weights.
The four shoulder muscles that make up the rotator cuff can get worn or tear. Strengthening all exercises painfree rom only 3xweek max. 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. After an injury or surgery, an exercise conditioning program will help you return to daily activities and enjoy a more active, healthy lifestyle. Clv pt arthroscopic rotator cuff repair small rehab protocol. These tears are usually chronic in nature and often involve poor tissue quality with fatty infiltration and muscle atrophy. Stretching and strengthening the muscles of the shoulder and scapula. Rotator cuff rupture an overview sciencedirect topics. Tear size largemassive tear or 1 tendon repair difficult to. At your first postop visit you will be given a copy of the operative report which will. Rotator cuff repair most rotator cuff tears can be repaired surgically by reattaching the torn tendons to the humerus. This rotator cuff strain rehabilitation program is based around four stages.
Clinical practice guidelines for the management of rotator. Shoulder pain may be caused by inflammation or injury to the rotator cuff. None stepbystep directions lean forward and place one hand on a counter or table for support. The rotator cuff is made up of 4 muscles supraspinatus, infraspinatus, subscapularis, and teres minor that help stabilize the shoulder. Rehabilitation of rotator cuff injuries consists of four elements. It is prone to injury, but doing specific exercises can help prevent this. Rotator cuff repair small to medium rehabilitation guideline. The deltoid muscle is separated to expose the torn. Shoulder rotator cuff repair oxford university hospitals. Patients over 50 years of age are more susceptible to sustaining a significant rotator cuff tear from trauma. Rehabilitation protocol for rotator cuff repair massachusetts. A rotator cuff tear of greater than 5 cm is considered a massive tear. The rotator cuff is a group of muscles closely wrapped around the. Rotator cuff and shoulder conditioning program orthoinfo aaos.
Talk to your doctor or physical therapist about which exercises will best help you meet your rehabilitation goals. Learn how your shoulder therapy progresses with a rehab timeline and. Start to lower your arm slowly, all the way to the side of your body. The chronic nature of these tears along with poor underlying quality of the tissue often results in recurrent tears.
The rotator cuff is made up of four muscles supraspinatus, infraspinatus, subscapularis, and teres minor and their tendons. According to general population surveys, the prevalence of rotator cuff tear is 25 % in those older than 50 years of age and 20 % in those older than 20 years of age. This is great for anyone experiencing chronic pain that needs to rehab their injury to prevent a rotator cuff tear or rotator cuff surgery. The complete rotator cuff tear guide for physical therapy. The rotator cuff controls the shoulders movement and helps keep it stable. 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.
Exercises you can do at home exercises are a very important part of treatment for a rotator cuff disorder. 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. Rotator cuff tear rarely occurs before the age of 40 except in cases of severe acute trauma to the shoulder. With these tears, external rotation strengthening should be progressed at a slower rate.
The interesting thing is that only of the tears cause pain and 23 are without pain. If the tear is due in part to overuse, resting the shoulder may help. Emil diiorio discuss what you can expect in rehabilitation after an arthroscopic rotator cuff repair. The suturesanchors hold the tendons so they can heal back to the bone.
A small size rotator cuff tear is defined as a tear rehab may be altered depending upon the size of your tear and the quality of the tissue. In most cases, initial treatment for a rotator cuff tear is nonsurgical. Help and feedback was given from people who have had rotator cuff repair surgery. The rotator cuff is responsible for stabilization and active movement of the glenohumeral joint. The rotator cuff is a group of four muscles that stabilize the shoulder. Progress weight as tolerated painfree examine with elbow at side, usually progress faster to higher weights c. Modifications to this guideline may be necessary dependent on physician specific instruction, size and location of tear, tendons involved, acute vs. The rotator cuff is comprised of four muscles and tendons that surround the top of the upper arm bone humerus and functions to help rotate the arm and stabilize the shoulder joint. The rotator cuff is an integral part of the anatomy of the shoulder. Exercises and physical therapy for rotator cuff tear. This process alone can lead to rotator cuff tears in older patients. Initial treatment of the pain and functional disability associated with rotator cuff tear should include a combination of the nonsteroidal antiinflammatory agents or cox2 inhibitors and physical therapy.
Rotator cuff tears can be classified in various ways. Rotator cuff repair large to massive 5cm rehabilitation. Specific interventions should be based on the needs of the individual and should consider exam findings and clinical decision making. The acute stage, immediately after injury, recovery stage, functional stage and returning to full fitness. Rehabilitation after rotator cuff repair the open orthopaedics journal, 2017, volume 11 157 about the surgery, such as the size of the tear, the exact tendons involved, the quality of tissue and. 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.
Rotator cuff and shoulder rehabilitation exercises. Shoulder rotator cuff tear center for sports medicine. When you injure these muscles, exercising it is the best way to recover. It is designed for rehabilitation following large to massive rotator cuff repairs.
The drop arm test is done by abducting your shoulder to reach the arm up. Conservative rotator cuff tear protocol sports and orthopedic. Maintain arm in abduction sling brace, remove only for exercise. In rotator cuff repair surgery one or more of these muscles are reattached to the bone using anchorssutures. A rotator cuff tear may result suddenly from a single traumatic event or. Physical therapy to restore flexibility and strengthen the shoulder muscles. The first classification is a partial thickness or. Initiating rotator cuff and scapula stabilization strengthening exercises. Find out how physical therapy exercises and other treatment can help you feel better. If you have a rotator cuff injury, the following treatment may be helpful. 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. A large size rotator cuff tear is defined as a tear 35cm, massive 5cm. Take a break from activities or sports that may be aggravating your shoulder symptoms.
Considerations for the postoperative rotator cuff repair rehabilitation. Rehabilitation guidelines for type i and type ii rotator. It is no means intended to be a substitute for ones. It usually happens over time from normal wear and tear, or if. One high standard, three local partners for more information go to. Large rotator cuff repair protocol fowler kennedy sport. Use painkillers and or ice packs to reduce the pain before you exercise. Rehabilitation protocol for rotator cuff repair this protocol is intended to guide clinicians and patients through the postoperative course of a rotator cuff repair.