For more information, please visit the following webpages on orthoinfo.org: Please visit orthoinfo.org if your condition is not listed above. The information contained in these standards of care or protocols is not intended in any way to be used as primary medical advice or to replace medical advice offered by physical, occupational, speech therapists or other health care professionals. This information is not intended as a substitute for professional medical care. PDF Arthroscopic Rotator Cuff Repair Frequently Asked Questions: The damage may be due to: Recurrent pain, limited ability to move the arm, and muscle weakness are the most common symptoms. Surgical techniques that may be used to repair a tear of the rotator cuff include arthroscopy, open surgery, or a combination of both. They should not be copied or otherwise used without the permission of the Director of Rehabilitation Services. 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. The conservative approach may be associated with post-operative stiffness which can be managed once healing has occurred. Rotator Cuff Repair Protocol - Northwestern Medical Center Van der Meijden OA, W. P . The stitches or surgical staples will be removed during a follow-up office visit. 2012-04-12T06:10:33-04:00 The arthroscope (if used) will be put through the incision. (2016). skip to Cookie . Call 617-643-3333 if youre experiencing a sports injury. stream %gN+K(( 8VC|[WN#( Y2,,-_:,=t6h(#9 For over a century, a leader in patient care, medical education and research, with expertise in virtually every specialty of medicine and surgery. Arthroscopic Labral Repair Protocol-Type II, IV, and Complex Tears: endobj An IV (intravenous) line may be started in your arm or hand. Most commonly, however, this group of muscles co-contracts and . PDF Biceps Tenodesis Protocol - Brigham and Women's Hospital For more information about these cookies and the data Search for condition information or for a specific treatment program. 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. For surgery at the surgery center at Brigham and Women's Hospital/MGH Foxborough Report directly to the 4th Floor SHOULDER - ROTATOR CUFF REPAIR WITH SLAP REPAIR POSTOPERATIVE INSTRUCTIONS Phase One: the first week after surgery GOALS: Control pain and swelling Protect the rotator cuff repair Protect wound healing Athletes and construction workers often have rotator cuff injuries due to repetitive movement and overuse of the shoulder. You shouldn't drive until your surgeon tells you to. 02114. Shoulder injuries are common. PDF www.mghsportsmedicine.org Arthroscopic Labrum Repair of the Shoulder (SLAP) Mumford Procedure Surgery Rehab Protocol & Recovery Time - Kevin R. Stone collected, please refer to our Privacy Policy. You'll be asked to sign a consent form that gives your permission to do the procedure. *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 The following Standards of Care and Protocols are the property of BWH and should not be copied or otherwise used without the permission of the Director of Rehabilitation Services. The rotator cuff is made up of muscles and tendons that hold the shoulder in place. Arthroscopic Rotator Cuff Repair Frequently Asked Questions: Turners Cuff . You can ask questions. 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. collected, please refer to our Privacy Policy. MA Learn about career opportunities, search for positions and apply for a job. %PDF-1.7 ek'eY|&~ll%h$v,*`H. For very large tears, physical therapy may be delayed to promote rotator cuff healing up to 6 weeks postoperatively. 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. Damage may also happen slowly over time. You will eventually be prescribed strengthening exercises. The Sports Physical Therapy Service is an integral part of the Sports Medicine Center and the Department of Physical and Occupational Therapy. 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. For over a century, a leader in patient care, medical education and research, with expertise in virtually every specialty of medicine and surgery. Once youre home, its important to keep the surgical area clean and dry. The rotator cuff is a slow healing structure due to poor blood supply. When may I start strengthening? 1 Chung SW et al. Rotator Cuff Repair Rehab Protocol-Brigham and Women's Hospital. . Nonsurgical treatment may relieve pain and improve function in the shoulder; however, shoulder strength does not typically improve without surgery. 1 Oxford Road New Hartford, NY 13413. We use cookies and other tools to enhance your experience on our website and LL`}*Tg/#VA|5RQSVt*#bH|5 [oB]bPY) 1ULXv$6*jthb Ylv These muscles originate on the shoulder blade and attach to the humeral head. Recurrent pain, limited ability to move the arm, and muscle weakness are the most common symptoms. endobj 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. Rotator Cuff Tears - New England Baptist Hospital 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 Other activity restrictions may apply. Frequency of treatment will be determined by your specific needs together with the physician and physical therapist recommendations. Shoulder Precautions Regain range of motion 5. To help reduce swelling, you may be asked to apply an ice bag to the shoulder several times per day for the first few days. 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. 1 The intent of this Protocol is to provide the clinician with a guideline for the post-operative rehabilitation course of a patient that has undergone a Flexor Tendon Repair.It is by no means Brigham AND women 'S HOSPITAL intended to be a substitute for one's clinical decision-making regarding the progression of a A Teaching Affiliate of Harvard Medical School patient's post-operative course . Explore fellowships, residencies, internships and other educational opportunities. 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. 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. Protect the surgical repair 2. Mass General - Boston 175 Cambridge Street, 4th Floor We are committed to providing expert caresafely and effectively. ns6K2*\2 9LSs. % 4 0 obj Surgical techniques that may be used to repair a tear of the rotator cuff include arthroscopy, open surgery, or a combination of both. Women's Sports Medicine Rotator Cuff Repair The shoulder is a ball-and-socket joint: the head of the humerus (upper arm bone) fits into a socket in the shoulder blade. 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. About Us; Meet Our Team; Our Services; smoking, hypercholesterolemia and diabetes. This rehabilitation protocol has been developed for the patient following a large to massive rotator cuff surgical procedure. Rehabilitation Protocol for Rotator Cuff Repair-Small to Medium Sized Tears This protocol is intended to guide clinicians through the post-operative course for rotator cuff repair-small to medium tears. If your rotator cuff is injured, you may need to repair it surgically. 2 0 obj Mastersling with body . Rehabilitation following reverse total shoulder arthroplasty PDF Rotator Cuff Repair Protocol - Boston Shoulder Institute Ice shoulder 3 - 5 times (15 minutes each time) per day to control swelling and inflammation. Copyright 2007-2023. Continue to emphasize scapular stabilizers. Connect with us. The information contained in these standards of care or protocols is not intended in any way to be used as primary medical advice or to replace medical advice offered by physical, occupational, speech therapists or other health care professionals. Get the latest news, explore events and connect with Mass General. We provide our patients with comprehensive, coordinated care from experts who understand the unique needs of women in sports. Flexor Tendon Repair Protocol Zone 2-5 - Brigham and to analyze our web traffic. Mass General Brigham's Sports Medicine Program now offers urgent access virtual visits. We pride ourselves in the quality of patient care we provide and how we compare with other hospitals. You'll be positioned on the operating table. Stay Informed. They should not be copied or otherwise used without the permission of the Director of Rehabilitation Services. The following Standards is Care and Protocols are the real away BWH and should not be copied or otherwise used without the get of the Director of Rehabilitation Services. PDF Rotator Cuff Repair with Biceps Tenotomy/Tenodesis 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, 2023Brigham and Women's Faulkner Hospital. It's one of the most important parts of the shoulder. Avoid excessive reaching and external/internal rotation for the first 6 weeks. Connect with us. The incision will be closed with stitches or surgical staples. This philosophy of patient- and family-focused care involves systems and services that emphasize healing in a comfortable, relaxed environment. Light active scapular strengthening . PDF ARTHROSCOPIC ROTATOR CUFF REPAIR - Brigham and Women's Faulkner Hospital If the rotator cuff is injured, it may need to be repaired surgically. The conservative rehabilitation protocol allows Sharpey fibers to form before stressing the repair with resistive exercises. This protocol will vary in length and aggressiveness depending on factors such as: Women's Orthopedic and Joint Disease Center, Anesthesiology, Perioperative and Pain Medicine. After surgery you'll be taken to the recovery room for observation. In older patients, there may not be an injury or event to cause the tear. 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. In arthroscopic shoulder repair, the surgeon inserts a small camera called an arthroscope into the shoulder joint, which displays pictures onto a screen so that the surgeon may guide surgical instruments. Connect with us. 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. This guideline is designed to PDF Rotator Cuff Repair (Small to Medium) Rehabilitation Guideline Your surgeon will make a cut (incision) in the shoulder area. Mass General Brigham's network of Harvard Medical School-affiliated experts leads the nation in sports medicine research, technology, and innovations. It consists of a system of lenses, a small video camera, and a light for viewing. For more information about these cookies and the data For more information about these cookies and the data Boston, <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> endobj Mass General Brigham's network of Harvard Medical School-affiliated experts leads the nation in sports medicine research, technology, and innovations. 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. augment suture repair of the rotator armband tendon in 2 stud-. COPYRIGHT*2014*CRC*"BRIAN*J. This evidence-based small to medium rotator cuff repair physical therapy guideline is criterion-based; time frames and visits in each phase will vary depending on many factors, including patient demographics, goals, and individual progress. The rotator cuff may be damaged from a fall or other injury to the shoulder. 2012-04-12T06:10:33-04:00 Procedures may vary depending on your condition and your providers practices. Start progressive rotator cuff and shoulder strengthening at 3 months - isometrics initially Initiate isotonic strengthening at 4 months (Theraband, dumbbells, Hughston's exercises, etc). <>/Metadata 1084 0 R/ViewerPreferences 1085 0 R>> Arthroscopic Rotator Cuff Repair is performed when there is a tear of one or more of the four muscles that comprise the Rotator Cuff. 3 0 obj Ensure wound healing 3. Numerous rehabilitation protocols for the management of rotator cuff disease are based primarily on . PDF SUBSCAPULARIS REPAIR REHABILITATION PROTOCOL - Dr. Brian J. Cole The arthroscope is often used along with other tools that are inserted through another small incision. The Orthopaedic & Arthritis Center at Brigham and Womens Hospital is one of the most highly regarded orthopaedic and joint disease research and treatment programs in the world. <>/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>> We have remained at the forefront of medicine by fostering a culture of collaboration, pushing the boundaries of medical research, educating the brightest medical minds and maintaining an unwavering commitment to the diverse communities we serve. 617-732-5500, New Patients: Rotator Cuff Repair - Brigham and Women's Hospital Using sutures and suture anchors, the torn muscle and tendon are sewn back to the bone where it was originally attached. endstream endobj 834 0 obj <>/Encoding<>>>>> endobj 826 0 obj <> endobj 164 0 obj <> endobj 166 0 obj <> endobj 167 0 obj <> endobj 168 0 obj <> endobj 2345 0 obj <> endobj 2346 0 obj <> endobj 2347 0 obj <> 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