brigham and women's rotator cuff repair protocol

Be sure to take only recommended medicines. 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. The rotator cuff is made up of muscles and tendons that hold the shoulder in place. Arthroscopic Rotator Cuff Repair Protocol: The intent of this protocol is to provide the clinician with a guideline of the post-operative rehabilitation course of a patient that has undergone an arthroscopic assisted/mini-open rotator cuff repair. The camera is connected to a monitoring system that allows the surgeon to view a joint through a very small incision. Equate active and passive range of motion. The conservative approach may be associated with post-operative stiffness which can be managed once healing has occurred. Once youre home, its important to keep the surgical area clean and dry. <>/Metadata 1084 0 R/ViewerPreferences 1085 0 R>> QlR#D' An arthroscope is a small, tube-shaped instrument that is inserted into a joint. The rotator cuff is a group of four muscles: the supraspinatus, the infraspinatus, the subscapularis, and the teres minor. ajp5 % Numerous rehabilitation protocols for the management of rotator cuff disease are based primarily on . COPYRIGHT*2014*CRC*"BRIAN*J. Explore fellowships, residencies, internships and other educational opportunities. It stabilizes the ball-and-socket joint of the shoulder and allows for normal shoulder mechanics. Based on your medical condition, your provider may request other specific preparation. You should keep the sling or immobilizer on as directed by your provider. Your provider will arrange for an exercise rehabilitation program to help you regain muscle strength, flexibility, and function of your shoulder. %PDF-1.6 % Generally, rotator cuff repair surgery follows this process: You'll be asked to remove clothing and given a gown to wear. 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. The rotator cuff consists of four muscles that come together as tendons to cover the head of the humerus. The Sports Physical Therapy Service is an integral part of the Sports Medicine Center and the Department of Physical and Occupational Therapy. Surgical techniques that may be used to repair a tear of the rotator cuff include arthroscopy, open surgery, or a combination of both. You may meet with a physical therapist before your surgery to talk about rehabilitation. 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. Aspirin or certain other pain medicines may increase the chance of bleeding. It allows you to lift your arm and reach up. Brigham and Women's Hospital, Division of Rheumatology, Inflammation, and Immunity, nonsteroidal anti-inflammatory medications. Boston, Rehab Plans and Exercises Minor Rotator Cuff Repair Protocol for Physiotherapy Following Surgery. The arthroscope is often used along with other tools that are inserted through another small incision. endobj Brigham and Women's Faulkner Hospital Rehabilitation Services1153 Centre Street, 2nd FloorBoston, MA 02130. Reverse or inverse total shoulder arthroplasty (rTSA) is becoming a widely accepted surgical intervention. For more information about these cookies and the data If the rotator cuff is injured, it may need to be repaired surgically. You may get a medicine (sedative) before the procedure to help you relax. The arthroscope is often used in conjunction with other tools that are inserted through another incision. Learn about career opportunities, search for positions and apply for a job. The conservative rehabilitation protocol allows Sharpey fibers to form before stressing the repair with resistive exercises. collected, please refer to our Privacy Policy. You can ask questions. Phase I: 1 through 4 to 6 weeks post-op: First 3 weeks: Patient education: movement limitations, posture, proper sling fitting, joint protection, and positioning. Quick Links. The type of anesthesia will depend on the specific procedure being done. You may resume your normal diet unless your provider advises you differently. L|5C[[ZW%pGY8JMe{+u'O=1m 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. Nonsurgical treatment may relieve pain and improve function in the shoulder; however, shoulder strength does not typically improve without surgery. 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. All rights reserved. Individually, these muscles either internally or externally rotate the humerus. Let us help you navigate your in-person or virtual visit to Mass General. It may be necessary for you to stop these medicines before the procedure. A surgical repair is indicated when pain MD follow-up visits at Day 1, Day 14 . Full recovery from the surgery may take several months. The rotator cuff consists of four muscles that come together as tendons to cover the head of the humerus. The American Society of Shoulder and Elbow Therapists' consensus statement on rehabilitation following arthroscopic rotator cuff repair. 617-732-5500, New Patients: Acrobat Distiller 8.0.0 (Windows) . This usually involves reattaching the tendon to the head of the humerus. x=n8zE$ 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. Search for condition information or for a specific treatment program. 2000-2023 The StayWell Company, LLC. NEW HARTFORD. We use cookies and other tools to enhance your experience on our website and This protocol is time based (dependent on tissue healing) as well as criterion based. It consists of a system of lenses, a small video camera, and a light for viewing. BRIGHAM AND WOMEN'S HOSPITAL. They should not be copied or otherwise used without the permission of the Director of Rehabilitation Services. 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 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. Learn about Real Therapy Standards of Care and Protocols since that Rehabilitation Services at Brightam additionally Women's Infirmary. Your recovery process will vary depending on the type of anesthesia that is given and the type of surgery thats done. There are a number of different anchoring techniques that surgeons are currently using. For more information about these cookies and the data The incision will vary depending on the type of surgery (open surgery, arthroscopy, or a combination of both) that may be done. There may be other reasons for your healthcare provider to recommend rotator cuff repair. HWMo8W(oQ@QIECw^8++kJdGvqd7FWzj7,N.NlI~Kk6}b6}%O, Microsoft Word - Rotator cuff and SLAP patient info.doc. %PDF-1.7 Rotator Cuff Repair Rehab Protocol-Brigham and Women's Hospital. The shoulder is a ball-and-socket joint: the head of the humerus (upper arm bone) fits into a socket in the shoulder blade. Surgery for rotator cuff repair involves the reattachment of the tendon to the humeral head. Stay Informed. For more information, please visit the following webpages on orthoinfo.org: Please visit orthoinfo.org if your condition is not listed above. Turners Cuff . collected, please refer to our Privacy Policy. You'll be asked to sign a consent form that gives your permission to do the procedure. Rotator cuff surgery may be done using an arthroscope. For more information about these cookies and the data Mass General Brigham's Sports Medicine Program now offers urgent access virtual visits. Some possible complications may include: The joint pain and weakness may not be relieved by the surgery. collected, please refer to our Privacy Policy. For more information about these cookies and the data smoking, hypercholesterolemia and diabetes. Shoulder injuries are common. 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. PROM shoulder flexion/abduction/ER/IR. 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 Its one of the most important parts of the shoulder. }@o~+msq8JJ|vd24a2e> It allows you to lift your arm and reach up. 2023 LL`}*Tg/#VA|5RQSVt*#bH|5 [oB]bPY) 1ULXv$6*jthb Ylv This results in weakness or numbness. The rotator cuff keeps the shoulder in the socket. The skin over your surgical site will be cleaned with an antiseptic solution. %gN+K(( 8VC|[WN#( Y2,,-_:,=t6h(#9 stream Rehabilitation after Rotator Cuff Repair. 2 0 obj 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. Journal of Shoulder and Elbow Surgery, 4:521-535. Rotator cuff surgery may be performed using an arthroscope. 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. 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. collected, please refer to our Privacy Policy. At Mass General, the brightest minds in medicine collaborate on behalf of our patients to bridge innovation science with state-of-the-art clinical medicine. Connect with us. ns6K2*\2 9LSs. Always follow your healthcare professional's instructions. Connect with us. Elbow/wrist/hand AROM w/ no resistance. <>/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>> For over a century, a leader in patient care, medical education and research, with expertise in virtually every specialty of medicine and surgery. This may include shaving off bone spurs that are pinching the shoulder, and repairing torn tendons or muscles in the shoulder. Connect with us. Microsoft Word - Rotator cuff and SLAP patient info.doc Ensure wound healing 3. 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. % This information is not intended as a substitute for professional medical care. 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. Most commonly, however, this group of muscles co-contracts and . Connect with us. When one or more of the tendons in the rotator cuff is torn, it no longer fully attaches to the head of the humerus. There may be other risks depending on your specific medical condition. 5. 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. In some cases, a tendon graft or joint replacement may be needed. Mass General Brigham's network of Harvard Medical School-affiliated experts leads the nation in sports medicine research, technology, and innovations. This rehabilitation protocol has been developed for the patient following a large to massive rotator cuff surgical procedure. Prevent shoulder stiffness 4. Rehabilitation Services at Brigham & Women's Hospital has accepted a modification of this protocol as our standard protocol for the management of patient's s/p arthroscopic repair of Type II and IV SLAP lesions. endobj You may undergo blood tests or other diagnostic tests. ntr>&TZt`3o6?=^_.9|0dd\H c9{+'+::A{NhV{. 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 {QHCr!3g6jE6YQ` Your surgeon will give you specific bathing instructions. 800-294-9999. Start progressive rotator cuff and shoulder strengthening at 3 months - isometrics initially Initiate isotonic strengthening at 4 months (Theraband, dumbbells, Hughston's exercises, etc). <> 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. We provide our patients with comprehensive, coordinated care from experts who understand the unique needs of women in sports. Arthroscopic Labral Repair Protocol-Type II, IV, and Complex Tears: If you're pregnant or think that you could be pregnant, tell your provider. 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. After surgery you'll be taken to the recovery room for observation. About Us; Meet Our Team; Our Services; endstream endobj 770 0 obj<>stream 3. The presence of a RCT can cause a vast array of impairments and associated dysfunctions. The tendons attach the humerus to the shoulder blade and aids in lifting and rotating the arm. You may be given an immobilizer or sling before you go home. 02114. 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 and BWFH. `6B3}"{PT(3 _x g"8. 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. 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. to analyze our web traffic. Your provider will discuss this with you in advance. 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. The rotator cuff is a slow healing structure due to poor blood supply. Rehabilitation after Arthroscopic Labrum Repair of the Shoulder (SLAP) Phase One: 0 to 4 weeks after surgery Goals: 1. Get the latest news, explore events and connect with Mass General. 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. <> You will eventually be prescribed strengthening exercises. 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. The circulation and sensation of your arm will be monitored. Arthroscopic Rotator Cuff Repair Frequently Asked Questions: It's one of the most important parts of the shoulder. Damage may also occur slowly over time. Medical treatments for rotator cuff injury may include the following: Nonsteroidal anti-inflammatory drugs (NSAIDs). Healing occurs at a rate of 10% per month. Qle_EN ^l x][~G[" $`u[6=nwgz~HH[6M} ^|jg4?/>=W6ugqAxi??='O71R +gA^V%w?h0J6 }l?x)?VQ,QK-XTS1aM Rotator cuff strengthening with light Theraband - ER and IR with arm at side and pillow or towel roll under arm - Flexion to 60 degrees - Abduction to 60 degrees - Scaption to 60 degrees - Extension to 30 degrees Standing rows with Theraband Prone scapular retraction exercises (with light weight) Ball on wall (arcs, alphabet) <>/Metadata 702 0 R/ViewerPreferences 703 0 R>> to analyze our web traffic. 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. 2012-04-12T06:10:33-04:00 Other activity restrictions may apply. Dr. O'Holleran is Fellow, Harvard Shoulder . If your rotator cuff is injured, you may need to repair it surgically. 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. Light active scapular strengthening . collected, please refer to our Privacy Policy. Brigham and Women's Hospital, Boston. Small/Medium Rotator Cuff Repair Protocol; Subscapularis Repair Protocol; Superior Capsule Repair Protocol; Triceps Tendon Repair Protocol; Locations: HAMILTON.

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