PDF Arthroscopic Labral Repair Protocol, II, IV, and complex tears Boston Rotator Cuff Surgery - Brigham and Women's Hospital 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. ntr>&TZt`3o6?=^_.9|0dd\H c9{+'+::A{NhV{. 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. 3 0 obj Rotator cuff surgery may be performed using an arthroscope. Copyright 2007-2023. Recurrent pain, limited ability to move the arm, and muscle weakness are the most common symptoms. Learn about the many ways you can get involved and support Mass General. Get the latest news, explore events and connect with Mass General. Connect with us. (2016). 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. The anesthesiologist or nurse anesthetist will continuously monitor your heart rate, blood pressure, breathing, and blood oxygen level during the surgery. 3 0 obj Maintain good upright shoulder girdle posture at all times and especially during sling use. to analyze our web traffic. The circulation and sensation of your arm will be monitored. collected, please refer to our Privacy Policy. Your provider will arrange for an exercise rehabilitation program to help you regain muscle strength, flexibility, and function of your shoulder. Frequency of treatment will be determined by your specific needs together with the physician and physical therapist recommendations. 3. 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. 800-294-9999. Pre-op. Avoid excessive reaching and external/internal rotation for the first 6 weeks. Let us help you navigate your in-person or virtual visit to Mass General. 1 0 obj Rotator cuff surgery may be done using an arthroscope. uuid:463caef0-aa5d-4b8f-bc94-142f9b3774d9 Elbow/wrist/hand AROM w/ no resistance. You'll be asked to sign a consent form that gives your permission to do the procedure. An arthroscope is a small, tube-shaped instrument that is inserted into a joint. PDF Arthroscopic Repair of RTC tear SOC - Brigham and Women's Hospital 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. A surgical repair is indicated when pain 2 0 obj You may resume your normal diet unless your provider advises you differently. <>/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>> 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. PDF Reverse Total Shoulder Replacement Therapy Protocol 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. Physical Therapy Standards of Care - Brigham and Women's Hospital Women's Orthopedic and Joint Disease Center, Anesthesiology, Perioperative and Pain Medicine. An open repair may be done if the rotator cuff injury cant be repaired using arthroscopy. application/pdf Its one of the most important parts of the shoulder. You may get a medicine (sedative) before the procedure to help you relax. 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. Your recovery process will vary depending on the type of anesthesia that is given and the type of surgery thats done. PDF ARTHROSCOPIC ROTATOR CUFF REPAIR - Brigham and Women's Faulkner Hospital You may be given an immobilizer or sling before you go home. The rotator cuff may be damaged from a fall or other injury to the shoulder. The surgeon will fix or replace injured tendons and muscles with a graft tendon from another part of the body. Equate active and passive range of motion. Find PDFs of our most common rehabilitation protocols. COPYRIGHT*2014*CRC*"BRIAN*J. We pride ourselves in the quality of patient care we provide and how we compare with other hospitals. Call 617-643-3333 if youre experiencing a sports injury. Read the form carefully and ask questions if something isn't clear. stream It stabilizes the ball-and-socket joint of the shoulder and allows for normal shoulder mechanics. In the case of a delayed therapy start, the following timeframes are to be adjusted so that day 1 is the first day of therapy. to analyze our web traffic. HWMo8W(oQ@QIECw^8++kJdGvqd7FWzj7,N.NlI~Kk6}b6}%O, Microsoft Word - Rotator cuff and SLAP patient info.doc. PDF Rehabilitation Protocol for Rotator Cuff Repair-Small to Medium Sized Tears Connect with us. *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 It consists of a system of lenses, a small video camera, and a light for viewing. Control pain and swelling Activities: 1. Regain range of motion 5. L|5C[[ZW%pGY8JMe{+u'O=1m They should not be copied or otherwise used without the permission of the Director of Rehabilitation Services. 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. @O]2QCl*x[c@V(.G?L(#? Athletes and construction workers often have rotator cuff injuries due to repetitive movement and overuse of the shoulder. The presence of a RCT can cause a vast array of impairments and associated dysfunctions. %gN+K(( 8VC|[WN#( Y2,,-_:,=t6h(#9 repair, other BEAR procedure, real ACL reconstructing in pre- chronic models.21,33 . It consists of a system of lenses, a small video camera, and a light for viewing. This protocol is time based (dependent on tissue healing) as well as criterion based. The rotator cuff consists of four muscles that come together as tendons to cover the head of the humerus. 617-732-5500, New Patients: 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. 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. 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. The type of anesthesia will depend on the specific procedure being done. This results in weakness or numbness. We provide our patients with comprehensive, coordinated care from experts who understand the unique needs of women in sports. Mass General - Boston MD follow-up visits at Day 1, Day 14 . biceps tenodesis procedure involves cutting of the long head of the biceps just prior to its insertion on the superior labrum and then anchoring the tendon along its anatomical course more distally along the humerus. In older patients, there may not be an injury or event to cause the tear. General Information: 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. Using sutures and suture anchors, the torn muscle and tendon are sewn back to the bone where it was originally attached. If the rotator cuff is injured, it may need to be repaired surgically. ;#O#t4\i_"+O/G?|tg1}*$27VsO] k\pU2=" Aspirin or certain other pain medicines may increase the chance of bleeding. This may include shaving off bone spurs that are pinching the shoulder, and repairing torn tendons or muscles in the shoulder. Learn about Real Therapy Standards of Care and Protocols since that Rehabilitation Services at Brightam additionally Women's Infirmary. 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. 2000-2023 The StayWell Company, LLC. Your provider will explain the procedure to you. Some possible complications may include: The joint pain and weakness may not be relieved by the surgery. 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. Physical Therapy Protocols - Brigham and Women's Faulkner Hospital Nerves or blood vessels in the area of surgery may be injured. The incision will vary depending on the type of surgery (open surgery, arthroscopy, or a combination of both) that may be done. We use cookies and other tools to enhance your experience on our website and 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. An arthroscope is a small, tube-shaped instrument that is inserted into a joint. Medical treatments for rotator cuff injury may include the following: Nonsteroidal anti-inflammatory drugs (NSAIDs). 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 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. collected, please refer to our Privacy Policy. 5. You should keep the sling or immobilizer on as directed by your provider. LL`}*Tg/#VA|5RQSVt*#bH|5 [oB]bPY) 1ULXv$6*jthb Ylv %PDF-1.7 Your surgeon will make a cut (incision) in the shoulder area. Flexor Tendon Repair Protocol Zone 2-5 - Brigham and Shoulder injuries are common. Based on your medical condition, your provider may request other specific preparation. 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) Damage may also happen slowly over time. Bone spurs will be removed if there are any. 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 camera is connected to a monitoring system that allows the doctor to view a joint through a very small incision. 4 0 obj The following Protocols are the property of Brigham and Women's Hospital (BWH) and are linked here with permission. Ice shoulder 3 - 5 times (15 minutes each time) per day to control swelling and inflammation. The skin over your surgical site will be cleaned with an antiseptic solution. Rotator cuff degeneration and tears may also be caused by aging. This philosophy of patient- and family-focused care involves systems and services that emphasize healing in a comfortable, relaxed environment. An arm sling is used for 4 weeks post-op. The American Society of Shoulder and Elbow Therapists' consensus statement on rehabilitation following arthroscopic rotator cuff repair. 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. Other incisions may be made to use other small grasping, probing, or cutting tools. Boston, Rotator Cuff Repair Rehab Protocol-Brigham and Women's Hospital. Reverse or inverse total shoulder arthroplasty (rTSA) is becoming a widely accepted surgical intervention. stream For more information about these cookies and the data 85 College Street Hamilton, NY 13346. 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