Ice shoulder 3 - 5 times (15 minutes each time) per day to control swelling and inflammation. You shouldn't drive until your surgeon tells you to. 617-732-5500, New Patients: endobj When one or more of the tendons in the rotator cuff is torn, it no longer fully attaches to the head of the humerus. Your recovery process will vary depending on the type of anesthesia that is given and the type of surgery thats done. General Information: 2012-04-12T06:10:33-04:00 Damage may also happen slowly over time. 175 Cambridge Street, 4th Floor HMn0F:N@_A"'( -P7Ul8 >qr5i>M___c*h?) You may be given an immobilizer or sling before you go home. <> <>/XObject<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 32 0 R 33 0 R 34 0 R] /MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> The intent of posting these standards of care and protocols is to provide clinicians and patients an understanding of our current standards of care and protocols at BWH. endobj The anesthesiologist or nurse anesthetist will continuously monitor your heart rate, blood pressure, breathing, and blood oxygen level during the surgery. An arthroscope is a small, tube-shaped instrument that is inserted into a joint. PDF Rehabilitation Protocol Lower Trapezius Tendon Transfer to Greater Light active scapular strengthening . You can ask questions. Flexor Tendon Repair Protocol Zone 2-5 - Brigham and About Us; Meet Our Team; Our Services; The goal of rotator cuff repair surgery is to help restore the function and flexibility of the shoulder and to relieve the pain that cant be controlled by other treatments. 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. Abstract. . All rights reserved. Ensure wound healing 3. % For over a century, a leader in patient care, medical education and research, with expertise in virtually every specialty of medicine and surgery. A surgical repair is indicated when pain Follow any directions you're given about not eating or drinking before your procedure. SUBSCAPULARIS REPAIR REHABILITATION PROTOCOL ! Today, the Center a collaboration of the Department of Orthopaedic Surgery and the Division of Rheumatology, Inflammation, and Immunity - is known for its pioneering team of physicians and researchers dedicated to doing everything possible for our patients while helping to develop and apply the most advanced treatments for bone and joint diseases and conditions. PDF Rotator Cuff Repair (Small to Medium) Rehabilitation Guideline Rotator cuff tears (RCT) are frequent and increase with age, yet the varying functional implications of a tear can have a unique and dramatic impact on a patient's daily life. Connect with us. 1 0 obj 2000-2023 The StayWell Company, LLC. Physical Therapy Standards of Care - Brigham and Women's Hospital This results in weakness or numbness. Always follow your healthcare professional's instructions. The Sports Physical Therapy Service is an integral part of the Sports Medicine Center and the Department of Physical and Occupational Therapy. The rotator cuff may be damaged from a fall or other injury to the shoulder. Medical treatments for rotator cuff injury may include the following: Nonsteroidal anti-inflammatory drugs (NSAIDs). PDF Rotator Cuff Repair Protocol - Boston Shoulder Institute If you believe you should have an evaluation and would like to schedule an appointment with one of our orthopaedic surgeons for rotator cuff surgery, knee replacement surgery or hip replacement surgery, call 1-800-294-9999 to speak to one of our knowledgeable coordinators who can help to connect you to the doctor that best meets your needs, or fill out an online appointment request form. Small/Medium Rotator Cuff Repair Protocol; Subscapularis Repair Protocol; Superior Capsule Repair Protocol; Triceps Tendon Repair Protocol; Locations: HAMILTON. If your rotator cuff is injured, you may need to repair it surgically. stream Include home cuff strengthening program. It may be necessary for you to stop these medicines before the procedure. Women's Orthopedic and Joint Disease Center, Anesthesiology, Perioperative and Pain Medicine. PDF Arthroscopic Repair of RTC tear SOC - Brigham and Women's Hospital Regain range of motion 5. We use cookies and other tools to enhance your experience on our website and PDF BANKART REPAIR REHABILITATION PROTOCOL (Arthroscopic/Open) Rotator Cuff Repair with Biceps Tenotomy/Tenodesis Post-Operative Protocol Phase I - Maximum Protection (Weeks 0 to 6): Goals: o Reduce inflammation o Decrease pain o Postural education o PROM as instructed Restrictions/Exercise Progression: o Sling for 6 weeks per Dr. Bjerke's instructions to analyze our web traffic. x=n8zE$ General Information: Rotator Cuff Repair - Brigham and Women's Hospital 02114. Equate active and passive range of motion. Brigham and Womens Hospital is committed to providing all of our patients with the safest, highest-quality, most-satisfying care possible and following established protocols that have been shown to improve patient outcomes. Your health and safety remain our top priority: Learn about our Safe Care Commitment | Use our Prescreen app before arrival for faster entry | Read the COVID-19 Vaccine FAQs. Offering comprehensive medical, surgical and psychiatric care as well as complete emergency, ambulatory and diagnostic services to residents of southwest Boston and the surrounding suburbs. QlR#D' Acrobat Distiller 8.0.0 (Windows) The incision will be closed with stitches or surgical staples. An IV (intravenous) line may be started in your arm or hand. Using sutures and suture anchors, the torn muscle and tendon are sewn back to the bone where it was originally attached. Avoid excessive reaching and external/internal rotation for the first 6 weeks. Pre-op. 175 Cambridge Street, 4th Floor Boston, MA 02114 Phone: 617-643-9999 Fax: 617-643-0822 Knee ACL Injuries - Non-operative Management ACL Reconstruction Autologous Chondrocyte Implantation (ACI)-Femoral Autologous Chondrocyte Implantation (ACI)-Patella High Tibial Osteotomy Protocol Iliotibial Band Syndrome You may meet with a physical therapist before your surgery to talk about rehabilitation. PDF SUBSCAPULARIS REPAIR REHABILITATION PROTOCOL - Dr. Brian J. Cole An arthroscope is a small, tube-shaped instrument that is inserted into a joint. This protocol will vary in length and aggressiveness depending on factors such as: Rehab Plans and Exercises Minor Rotator Cuff Repair Protocol for Physiotherapy Following Surgery. Surgical techniques that may be used to repair a tear of the rotator cuff include arthroscopy, open surgery, or a combination of both. These treatments may include: rest, activity modification, non-steroidal anti-inflammatory medication and physical therapy. The goal of rotator cuff repair surgery is to help restore the function and flexibility of the shoulder and to relieve the pain that cannot be controlled by other treatments. 3 0 obj @O]2QCl*x[c@V(.G?L(#? The conservative rehabilitation protocol allows Sharpey fibers to form before stressing the repair with resistive exercises. The skin over your surgical site will be cleaned with an antiseptic solution. Arthroscopic Rotator Cuff Repair is performed when there is a tear of one or more of the four muscles that comprise the Rotator Cuff. Sports Medicine Physical Therapy Rehabilitation Protocols It allows you to lift your arm and reach up. MD follow-up visits at Day 1, Day 14 . The incision will vary depending on the type of surgery (open surgery, arthroscopy, or a combination of both) that may be done. augment suture repair of the rotator armband tendon in 2 stud-. Physical Therapy Standards of Care - Brigham and Women's Hospital The intent of posting these criteria a care and protocols a to provide clinicians and patients an understanding of ours current standards of care and protocols at BWH. Physical Therapy Protocols - Brigham and Women's Faulkner Hospital Journal of Shoulder and Elbow Surgery, 4:521-535. Connect with us. Open Orthop J, 11:154162. Generally, rotator cuff repair surgery follows this process: You'll be asked to remove clothing and given a gown to wear. ntr>&TZt`3o6?=^_.9|0dd\H c9{+'+::A{NhV{. The rotator cuff consists of four muscles that come together as tendons to cover the head of the humerus. 2012-04-12T06:10:33-04:00 Because the sedative may make you drowsy, you'll need to arrange for someone to drive you home. 3. 2 0 obj Aspirin or certain other pain medicines may increase the chance of bleeding. 617-732-5500, Learn more about our sports medicine offerings, Rotator Cuff Tears: Frequently Asked Questions, Rotator Cuff Tears: Surgical Treatment Options, Rotator Cuff and Shoulder Conditioning Program, Anesthesiology, Perioperative and Pain Medicine. Damage may also occur slowly over time. uuid:5fa44141-9c8c-4c9c-b6ca-f862302a5ebb Individually, these muscles either internally or externally rotate the humerus. It stabilizes the ball-and-socket joint of the shoulder and allows for normal shoulder mechanics. The conservative approach may be associated with post-operative stiffness which can be managed once healing has occurred. PDF Rehabilitation of the Rotator Cuff: An Evaluation-Based Approach *COLE,*MD,*MBA RANGE OF MOTION IMMOBILIZER EXERCISES PHASE I 0-6 weeks 0-3 weeks: None 3-6 weeks: Begin PROM Limit 90 flexion, 45 ER, 20 extension 0-2 weeks: Immobilized at all times day and night Off for hygiene and gentle home exercise according to A sterile bandage or dressing will be applied. uuid:463caef0-aa5d-4b8f-bc94-142f9b3774d9 Rk.*Ec;g[tG$uVR/vr{O'?= 0?~zEq;*_~f~*axq{qz"ez*^L3_'0/B/''`Do5(C ORs"5>:x8= w l=q6[:!P nh;$+{/Ca p(3QOWhPj0*dpJLOq(X/_l,8Vy/_d0[ g|N!$e$=~HC=:"@("mK0e4o{p$`Y??D :]Lco139R;K)=QUvz x|r =p+43 Athletes and construction workers often have rotator cuff injuries due to repetitive movement and overuse of the shoulder. <> (2016). It stabilizes the ball-and-socket joint of the shoulder and allows for normal shoulder mechanics. 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. 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 and eventually require rotator cuff surgery. This procedure is specifically designed for the treatment of glenohumeral (GH) joint arthritis or complex fractures, when associated with irreparable rotator cuff (RC) damage or in the presence of RC arthropathy. 2 0 obj /*jthpUxYl*ABB'.4dG^td}AU PDF Rotator Cuff Repair Protocol LL`}*Tg/#VA|5RQSVt*#bH|5 [oB]bPY) 1ULXv$6*jthb Ylv We offer diagnostic and treatment options for common and complex medical conditions. 4 0 obj <> 617-732-5500, Rehabilitation Services - Physical and Occupational Therapy, Arthroscopic Anterior Shoulder Stabilization Protocol, Latissimus Dorsi Tendon Transfer Protocol, Open Anterior Shoulder Stabilization Protocol, Posterior and Posterior Inferior Capsular Shift of the Shoulder Protocol, Proximal Humeral Fracture Open Reduction Internal Fixation (ORIF), Reverse (Inverse) Total Shoulder Arthroplasty Protocol, Rotator Cuff Repair Small to Medium Tear, Rotator Cuff Repair Large to Massive Tear, Ulnar Collatoral Ligament of the Elbow Reconstruction Protocol, Autologous Chondrocyte Implantation Protocol, Medial Patellofemoral Ligament (MPFL) Reconstruction, Post-operative Rehabilitation Protocol following Arthroscopic Hip Surgery for Femoroacetabular Impingement, Ankle Fracture with Open Reduction and Internal Fixation (ORIF), Brostrom Gould Repair for Ankle Instability, Functional Activity Progression Protocol following Lower Extremity Stress Injury, Return to Sport Following Knee Injury/Surgery, Running Injury Prevention Tips & Return to Running Program, Running Injury Prevention Tips & Strength Training Program, Reverse (Inverse) Total Shoulder Arthroplasty, Anterior Cruciate Ligament (ACL) Non-surgical Management, Non-Operative Management of Labral Tear of the Hip, Pelvic Floor Considerations in the Transgender and Gender Nonconforming Patient, Breast Reconstruction following Mastectomy, Physical Therapy Treatment of Blocked Milk Ducts, Inpatient-Specific Physical Therapy Standards of Care, Inpatient PT and OT Services: Main Campus, Anesthesiology, Perioperative and Pain Medicine. A surgical repair is indicated when pain cannot be managed with conservative methods and is associated with weakness that causes a significant loss of function. Rehabilitation after Arthroscopic Labrum Repair of the Shoulder (SLAP) Phase One: 0 to 4 weeks after surgery Goals: 1. Boston, Stay Informed. In some cases, a tendon graft and joint replacement may be necessary. We use cookies and other tools to enhance your experience on our website and Mass General Brigham's network of Harvard Medical School-affiliated experts leads the nation in sports medicine research, technology, and innovations. 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. ter rotator cuff repair is 30 of eleva-tion in the scapular plane, with 0 to Tell your provider if you're sensitive to or allergic to any medicines, latex, tape, and anesthetic agents (local and general). <> COPYRIGHT*2014*CRC*"BRIAN*J. In addition to a complete medical history, your provider may do a complete physical exam to make sure that you're in good health before undergoing the procedure. Physical Therapy Protocols Shoulder Elbow Hip/Knee Ankle Return to Sports Guidelines Physical Therapy Standards of Care Ankle Spine Shoulder Hip/Knee Lower Extremity Pelvic Health to analyze our web traffic. Anesthesia, Critical Care & Pain Medicine, Billing, Insurance & Financial Assistance, Autologous Chondrocyte Implantation (ACI)-Femoral, Autologous Chondrocyte Implantation (ACI)-Patella, Medial Patellofemoral Ligament (MPFL) Reconstruction, Microfracture of Femoral Condyle & Patella/Trochlear Groove, Osteochondral Autograft/Allograft Transfer System (OATS) Procedure, Acromioclavicular Joint Reconstruction (including Coracoclavicular Ligament Reconstruction), Clavicle Open Reduction Internal Fixation (ORIF), Proximal Humeral Fracture Open Reduction Internal Fixation (ORIF), Rotator Cuff Repair - Small to Medium Tear, Rotator Cuff Repair - Large to Massive Tear, Ankle Fracture with Open Reduction and Internal Fixation (ORIF), Medial & Lateral Epicondylitis (Golfers Elbow), Athletic Pubalgia (non-operative management), Hip Arthroscopy for Femoroacetabular Impingement, Interval Throwing Program Phase One - Long Toss, Interval Throwing Program Phase Two - Pitcher's Mound, Interval Throwing Program for Little League. endobj Back to Rehabilitation Services Physical Therapy Protocols The following Protocols are the property of Brigham and Women's Hospital (BWH) and are linked here with permission. The rotator cuff keeps the shoulder in the socket. Comprehensive and innovative bone and joint care is the foundation of the Center, beginning nearly a century ago when one of our founding hospitals, the Robert Breck Brigham Hospital, became the first teaching hospital in the country wholly devoted to arthritis treatment and related diseases. Connect with us. Medical treatments for rotator cuff injury may include, but are not limited to, the following: If medical treatments are not satisfactory, rotator cuff surgery may be an effective treatment for shoulder repair. Connect with us. ;#O#t4\i_"+O/G?|tg1}*$27VsO] k\pU2=" Day 1 - 3 weeks. Explore fellowships, residencies, internships and other educational opportunities. If pain does not improve with nonsurgical methods, surgery may be recommended. Let us help you navigate your in-person or virtual visit to Mass General. Call 617-643-3333 if youre experiencing a sports injury. Find PDFs of our most common rehabilitation protocols. PDF Biceps Tenodesis Protocol - Brigham and Women's Hospital In some cases, a tendon graft or joint replacement may be needed. For more information about these cookies and the data You may not recover full range of motion in the shoulder joint. The circulation and sensation of your arm will be monitored. You should keep the sling or immobilizer on as directed by your provider. Some possible complications may include: The joint pain and weakness may not be relieved by the surgery. Operative report should be read to determine the extent of rotator cuff involvement, integrity of the articular surface, involvement of the biceps tendon and glenoid labrum. x][~G[" $`u[6=nwgz~HH[6M} ^|jg4?/>=W6ugqAxi??='O71R +gA^V%w?h0J6 }l?x)?VQ,QK-XTS1aM The rotator cuff is made up of muscles and tendons that hold the shoulder in place. Tell your provider if you have a history of bleeding disorders or if you're taking any anticoagulant (blood-thinning) medicines, aspirin, or other medicines that affect blood clotting. Rotator Cuff Repair Rehab Protocol-Brigham and Women's Hospital. endobj For very large tears, physical therapy may be delayed to promote rotator cuff healing up to 6 weeks postoperatively. BRIGHAM AND WOMEN'S HOSPITAL. Mass General - Boston Your health and safety remain our top priority: Learn about our Safe Care Commitment | Use our Prescreen app before arrival for faster entry | Read the COVID-19 Vaccine FAQs. Our inpatient satisfaction survey, sent to patients to assess their total care experience, helps us to monitor what we are doing well and what areas may need improvement. Tell your provider about any of the following: Redness, swelling, bleeding, or other drainage from the incision site, Numbness or tingling in the affected arm or hand. The arthroscope is often used along with other tools that are inserted through another small incision. Before you agree to the test or the procedure make sure you know: The reason you're having the test or procedure, What results to expect and what they mean, The risks and benefits of the test or procedure, What the possible side effects or complications are, When and where you're to have the test or procedure, Who will do the test or procedure and what that persons qualifications are, What would happen if you didn't have the test or procedure, Any alternative tests or procedures to think about, Who to call after the test or procedure if you have questions or problems, How much you'll have to pay for the test or procedure. Adobe Acrobat 8.0 Combine Files 1 Chung SW et al. The type of anesthesia will depend on the specific procedure being done. PDF Rehabilitation Protocol for Rotator Cuff Repair-Small to Medium Sized Tears Surgical techniques that may be used to repair a tear of the rotator cuff include arthroscopy, open surgery, or a combination of both. Continue to emphasize scapular stabilizers. Physical Therapy Standards of Care and Protocol - Brigham and Women's The damage may be due to: Recurrent pain, limited ability to move the arm, and muscle weakness are the most common symptoms. The rotator cuff is a slow healing structure due to poor blood supply. Rehabilitation following reverse total shoulder arthroplasty Rotator Cuff Repair. Arthroscopic repair of massive rotator cuff tears: outcome and analysis of factors Protocol Delays: o The start of this protocol will be delayed 3-4 weeks following rTSR for a revision or in the presence of poor bone stock based on the surgeon's assessment of the integrity of the surgical repair. You may resume your normal diet unless your provider advises you differently. endobj These muscles originate on the shoulder blade and attach to the humeral head. Arthroscopic Labral Repair Protocol-Type II, IV, and Complex Tears: collected, please refer to our Privacy Policy. PDF Rotator cuff and SLAP patient info - Massachusetts General Hospital For more information, please visit the following webpages on orthoinfo.org: Please visit orthoinfo.org if your condition is not listed above. Other incisions may be made to use other small grasping, probing, or cutting tools. We use cookies and other tools to enhance your experience on our website and This guideline is designed to PDF Arthroscopic Labral Repair Protocol, II, IV, and complex tears Start progressive rotator cuff and shoulder strengthening at 3 months - isometrics initially Initiate isotonic strengthening at 4 months (Theraband, dumbbells, Hughston's exercises, etc). The tendons attach the humerus to the shoulder blade and aids in lifting and rotating the arm. MA 85 College Street Hamilton, NY 13346. Rotator cuff surgery may be done using an arthroscope. Surgery for rotator cuff repair involves the reattachment of the tendon to the humeral head. Women's Sports Medicine Rotator Cuff Repair - Brigham and Women's Hospital There may be other risks depending on your specific medical condition. Rotator cuff repair may be done on an outpatient basis or as part of your stay in a hospital. Stay Informed. Prevent shoulder stiffness 4. Once youre home, its important to keep the surgical area clean and dry. The presence of a RCT can cause a vast array of impairments and associated dysfunctions. The rotator cuff consists of muscles and tendons that hold the shoulder in place and allows a person to lift his and her arm and reach up. ns6K2*\2 9LSs. Reverse or inverse total shoulder arthroplasty (rTSA) is becoming a widely accepted surgical intervention. Nikolaidou O, M. S. (2017). This may include shaving off bone spurs that are pinching the shoulder or repairing torn tendons or muscles in the shoulder. endstream endobj 770 0 obj<>stream Once your blood pressure, pulse, and breathing are stable and you're alert, you'll be taken to your hospital room or discharged to your home. You may get a medicine (sedative) before the procedure to help you relax. PDF Arthroscopic Rotator Cuff Repair Frequently Asked Questions: ROM Exercises; Maximise shoulder strength of deltoid, intact cuff muscles and scapula stabilisers. ek'eY|&~ll%h$v,*`H. %PDF-1.6 % PDF ARTHROSCOPIC ROTATOR CUFF REPAIR - Brigham and Women's Faulkner Hospital You'll be asked to sign a consent form that gives your permission to do the procedure. %gN+K(( 8VC|[WN#( Y2,,-_:,=t6h(#9 The rotator cuff consists of muscles and tendons that hold the shoulder in place and allows a person to lift his and her arm and reach up. 3 0 obj to analyze our web traffic. It consists of a system of lenses, a small video camera, and a light for viewing. An arm sling is used for 4 weeks post-op. The following Protocols are the property of Brigham and Women's Hospital (BWH) and are linked here with permission. Take a pain reliever for soreness as recommended by your healthcare provider. collected, please refer to our Privacy Policy. Numerous rehabilitation protocols for the management of rotator cuff disease are based primarily on . The American Society of Shoulder and Elbow Therapists' consensus statement on rehabilitation following arthroscopic rotator cuff repair. Rotator cuff degeneration and tears may also be caused by aging. The rotator cuff is a group of four muscles: the supraspinatus, the infraspinatus, the subscapularis, and the teres minor. This information is not intended as a substitute for professional medical care. We use cookies and other tools to enhance your experience on our website and skip to Cookie . Mumford Procedure Surgery Rehab Protocol & Recovery Time - Kevin R. Stone

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