brigham and women's rotator cuff repair protocol brigham and women's rotator cuff repair protocol
Tech How Assam. For very large tears, physical therapy may be delayed to promote rotator cuff healing up to 6 weeks postoperatively. 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. 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. 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. Women's Orthopedic and Joint Disease Center, Anesthesiology, Perioperative and Pain Medicine. An arm sling is used for 4 weeks post-op. Take a pain reliever for soreness as recommended by your healthcare provider. Stay Informed. x][~G[" $`u[6=nwgz~HH[6M} ^|jg4?/>=W6ugqAxi??='O71R +gA^V%w?h0J6 }l?x)?VQ,QK-XTS1aM Brigham and Women's Faulkner Hospital Rehabilitation Services1153 Centre Street, 2nd FloorBoston, MA 02130. Continue to emphasize scapular stabilizers. /-BmN2'ux)>MxYLV#a$F]7W9.|EzuonDxH/?uXPoN,);? Physical Therapy Standards of Care - Brigham and Women's Hospital Physical Therapy Standards of Care and Protocol - Brigham and Women's BRIGHAM AND WOMEN'S HOSPITAL. 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. Microsoft Word - Rotator cuff and SLAP patient info.doc The rotator cuff is made up of muscles and tendons that hold the shoulder in place. (2016). HWMo8W(oQ@QIECw^8++kJdGvqd7FWzj7,N.NlI~Kk6}b6}%O, Microsoft Word - Rotator cuff and SLAP patient info.doc. ROM Exercises; Maximise shoulder strength of deltoid, intact cuff muscles and scapula stabilisers. Follow any directions you're given about not eating or drinking before your procedure. We use cookies and other tools to enhance your experience on our website and 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. 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. 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 You may meet with a physical therapist before your surgery to talk about rehabilitation. /*jthpUxYl*ABB'.4dG^td}AU We provide our patients with comprehensive, coordinated care from experts who understand the unique needs of women in sports. 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. 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. Flexor Tendon Repair Protocol Zone 2-5 - Brigham and PDF Rehabilitation of the Rotator Cuff: An Evaluation-Based Approach The American Society of Shoulder and Elbow Therapists' consensus statement on rehabilitation following arthroscopic rotator cuff repair. Learn about career opportunities, search for positions and apply for a job. Quick Links. 2000-2023 The StayWell Company, LLC. Shoulder injuries are common. Some possible complications may include: The joint pain and weakness may not be relieved by the surgery. 2012-04-12T06:10:33-04:00 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 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. 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. Shoulder Precautions These muscles originate on the shoulder blade and attach to the humeral head. `6B3}"{PT(3 _x g"8. HMn0F:N@_A"'( -P7Ul8 >qr5i>M___c*h?) 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. Recurrent pain, limited ability to move the arm, and muscle weakness are the most common symptoms. 1 0 obj PDF Rehabilitation Protocol: Massive Rotator Cuff Tear Repair - Lahey Health %gN+K(( 8VC|[WN#( Y2,,-_:,=t6h(#9 It may be necessary for you to stop these medicines before 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 There may be other reasons for your healthcare provider to recommend rotator cuff repair. A surgical repair is indicated when pain You may be given an immobilizer or sling before you go home. 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. Tell your provider about all prescription and over-the-counter medicines and herbal supplements that you're taking. The arthroscope is often used along with other tools that are inserted through another small incision. Expect full recovery to take up to 4 to 6 months. Healing occurs at a rate of 10% per month. <> You may not recover full range of motion in the shoulder joint. We use cookies and other tools to enhance your experience on our website and Read the form carefully and ask questions if something isn't clear. 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. collected, please refer to our Privacy Policy. Protect the surgical repair 2. The incision will be closed with stitches or surgical staples. L|5C[[ZW%pGY8JMe{+u'O=1m These treatments may include: rest, activity modification, non-steroidal anti-inflammatory medication and physical therapy. Stay Informed. Rehab Plans and Exercises Minor Rotator Cuff Repair Protocol for Physiotherapy Following Surgery. 2009-11-17T11:36:40-05:00 NEW HARTFORD. PDF Rehabilitation Protocol for Rotator Cuff Repair-Small to Medium Sized Tears This guideline is designed to 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. 5. 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. This protocol will vary in length and aggressiveness depending on factors such as: Surgical techniques that may be used to repair a tear of the rotator cuff include arthroscopy, open surgery, or a combination of both. General Information: collected, please refer to our Privacy Policy. We use cookies and other tools to enhance your experience on our website and 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. 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. 3 0 obj You will eventually be prescribed strengthening exercises. Surgical techniques that may be used to repair a tear of the rotator cuff include arthroscopy, open surgery, or a combination of both. It stabilizes the ball-and-socket joint of the shoulder and allows for normal shoulder mechanics. 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. <>/Metadata 702 0 R/ViewerPreferences 703 0 R>> A sterile bandage or dressing will be applied. Brigham and Womens Hospital has long been committed to not only the care of our patients but also the many other needs that they and their families have. The rotator cuff keeps the shoulder in the socket. PDF ARTHROSCOPIC ROTATOR CUFF REPAIR - Brigham and Women's Faulkner Hospital In some cases, a tendon graft or joint replacement may be needed. vywh0*-)Ha[ %2+$t^> K5$*{c Z Q.@B[,4nr^{.zlqE@`Cu.> Individually, these muscles either internally or externally rotate the humerus. endobj mqTdYqc#\*DgVx?,a6&&tO"TP_YV{zYNm[ Dj?mk^(^N7K1_Q P ? +!B8p+*.QnMXNjtt Damage may also occur slowly over time. PDF BANKART REPAIR REHABILITATION PROTOCOL (Arthroscopic/Open) You may get a medicine (sedative) before the procedure to help you relax. Arthroscopic Labral Repair Protocol-Type II, IV, and Complex Tears: to analyze our web traffic. Explore fellowships, residencies, internships and other educational opportunities. Connect with us. 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. collected, please refer to our Privacy Policy. There may be other risks depending on your specific medical condition. Full recovery from the surgery may take several months. Mass General Brigham's network of Harvard Medical School-affiliated experts leads the nation in sports medicine research, technology, and innovations. Journal of Shoulder and Elbow Surgery, 4:521-535. Connect with us. Stay Informed. 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 In older patients, there may not be an injury or event to cause the tear. uuid:463caef0-aa5d-4b8f-bc94-142f9b3774d9 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. collected, please refer to our Privacy Policy. MD follow-up visits at Day 1, Day 14 . An open repair may be performed if the rotator cuff injury cannot be repaired using arthroscopy. Extensor Tendon Injury Protocol | PDF | Thumb | Hand - Scribd endobj 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. Be sure to discuss any concerns with your provider before the procedure. Rotator Cuff Repair - Physical Therapy Haven COPYRIGHT*2014*CRC*"BRIAN*J. This may include shaving off bone spurs that are pinching the shoulder, and repairing torn tendons or muscles in the shoulder. QlR#D' application/pdf 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. Procedures may vary depending on your condition and your providers practices. Arthroscopic repair of massive rotator cuff tears: outcome and analysis of factors 1 0 obj Stay Informed. They should not be copied or otherwise used without the permission of the Director of Rehabilitation Services. The rotator cuff may be damaged from a fall or other injury to the shoulder. It consists of a system of lenses, a small video camera, and a light for viewing. You can ask questions. Your recovery process will vary depending on the type of anesthesia that is given and the type of surgery thats done. PDF Reverse Total Shoulder Replacement Therapy Protocol PDF Rotator cuff and SLAP patient info - Massachusetts General Hospital We use cookies and other tools to enhance your experience on our website and All rights reserved. Once youre home, its important to keep the surgical area clean and dry. It allows you to lift your arm and reach up. 617-732-5500, New Patients: Abstract. You may undergo blood tests or other diagnostic tests. 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. Ice shoulder 3 - 5 times (15 minutes each time) per day to control swelling and inflammation. Adobe Acrobat 8.0 Combine Files This may include shaving off bone spurs that are pinching the shoulder or repairing torn tendons or muscles in the shoulder. You shouldn't drive until your surgeon tells you to. PDF Arthroscopic Rotator Cuff Repair Frequently Asked Questions: 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. Your surgeon may give you other instructions after the procedure, depending on your particular situation. PROM shoulder flexion/abduction/ER/IR. 1 Oxford Road New Hartford, NY 13413. Rotator Cuff Repair. PDF Biceps Tenodesis Protocol - Brigham and Women's Hospital Control pain and swelling Activities: 1. The Sports Physical Therapy Service is an integral part of the Sports Medicine Center and the Department of Physical and Occupational Therapy. Your surgeon will give you specific bathing instructions. Your surgeon will make a cut (incision) in the shoulder area. Mass General Brigham's Sports Medicine Program now offers urgent access virtual visits. For over a century, a leader in patient care, medical education and research, with expertise in virtually every specialty of medicine and surgery. Acrobat Distiller 8.0.0 (Windows) This protocol is time based (dependent on tissue healing) as well as criterion based. Your provider will explain the procedure to you. 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. It consists of a system of lenses, a small video camera, and a light for viewing. <>/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>> 2012-04-12T06:10:33-04:00 The circulation and sensation of your arm will be monitored. The rotator cuff is a slow healing structure due to poor blood supply. Nerves or blood vessels in the area of surgery may be injured. Ensure wound healing 3. 02114. The type of anesthesia will depend on the specific procedure being done. endobj Be sure to take only recommended medicines. 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) We offer diagnostic and treatment options for common and complex medical conditions. Medical treatments for rotator cuff injury may include the following: Nonsteroidal anti-inflammatory drugs (NSAIDs). An open repair may be done if the rotator cuff injury cant be repaired using arthroscopy. 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. PDF Rotator Cuff Repair Protocol - Boston Shoulder Institute 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. The rotator cuff may be damaged from a fall or other injury to the shoulder. 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. Turners Cuff . If regional anesthesia is used, you'll have no feeling in your shoulder. We are committed to providing expert caresafely and effectively. A Teaching Affiliate of Harvard Medical School 75 Francis St. Boston, Massachusetts 02115. . 175 Cambridge Street, 4th Floor It's one of the most important parts of the shoulder. 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 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. 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. . Using sutures and suture anchors, the torn muscle and tendon are sewn back to the bone where it was originally attached. collected, please refer to our Privacy Policy. When one or more of the tendons in the rotator cuff is torn, it no longer fully attaches to the head of the humerus. The camera is connected to a monitoring system that allows the doctor to view a joint through a very small incision. PDF www.mghsportsmedicine.org Arthroscopic Labrum Repair of the Shoulder (SLAP) It allows you to lift your arm and reach up. }@o~+msq8JJ|vd24a2e> Aspirin or certain other pain medicines may increase the chance of bleeding. The arthroscope (if used) will be put through the incision. Thigpen, C. A. If medical treatments aren't working, rotator cuff repair surgery may be an effective treatment. 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. The presence of a RCT can cause a vast array of impairments and associated dysfunctions. Copyright 2007-2023. Mumford Procedure Surgery Rehab Protocol & Recovery Time - Kevin R. Stone 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 <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> The damage may be due to: Inflammation of the bursa (bursitis) in the shoulder, Inflammation of the tendons (tendinitis) in the shoulder. Rotator cuff repair may be done while you're asleep under general anesthesia or while you're awake under local or regional anesthesia. The rotator cuff consists of four muscles that come together as tendons to cover the head of the humerus. Rehabilitation after Arthroscopic Labrum Repair of the Shoulder (SLAP) Phase One: 0 to 4 weeks after surgery Goals: 1. 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. Its one of the most important parts of the shoulder. to analyze our web traffic. This philosophy of patient- and family-focused care involves systems and services that emphasize healing in a comfortable, relaxed environment. <> The stitches or surgical staples will be removed during a follow-up office visit. If you're pregnant or think that you could be pregnant, tell your provider. The rotator cuff is made up of muscles and tendons that hold the shoulder in place. The rotator cuff consists of four muscles that come together as tendons to cover the head of the humerus. PDF Rehabilitation Protocol Lower Trapezius Tendon Transfer to Greater The rotator cuff keeps the shoulder in the socket. Nonsurgical treatment may relieve pain and improve function in the shoulder; however, shoulder strength does not typically improve without surgery. Van der Meijden OA, W. P . 4. PDF Arthroscopic Repair of RTC tear SOC - Brigham and Women's Hospital 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 Get the latest news, explore events and connect with Mass General. Include home cuff strengthening program. 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. Light active scapular strengthening . Qle_EN ^l For more information about these cookies and the data In some cases, a tendon graft and joint replacement may be necessary. Elbow/wrist/hand AROM w/ no resistance. Rotator Cuff Repair | ShoulderDoc
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