SPORTS MEDICINE / SHOULDER SERVICE
OPERATIVE ROTATOR CUFF REPAIR PROTOCOL; ROUTINE
With or Without Distal Clavicle Excision
(Arthroscopic or Open)
Stage I (0-4 weeks)
A. Patient to wear sling or abduction pillow continuously for 4 weeks. The sling may be taken off for exercises, showering, and dressing. OK to do tabletop activities within pain tolerance (eat, brush teeth,write and occasional keyboard).
If in abduction brace or pillow, only PROM/AAOM above level of brace or pillow. The abduction brace is used only for patients with a problem with the deltoid; therefore, protect anterior deltoid.
*GOAL: Full PROM to pre-set limits or if no limits, to symmetric ROM
*PRECAUTIONS: Protect anterior deltoid
*VISITS: 6 visits (max) over 4 weeks
B. PROM/AAROM only to limits determined in operating room. If no limits on prescription, assume patient able to do full ROM.
1. Pendulum (Codman) exercises.
2. Wand exercises for PROM/AAROM exercises- supine only.
3. Strongly suggest home pulley use.
4. Ice following treatment and home exercises
5. Scapular stabilizing exercises (specifically scapular retraction).
6. Limit internal rotation to back pocket only.
Stage II (5-6 weeks)
A. AAROM progress from supine to standing
B. AROM, no weight, painfree arc only.
*PRECAUTIONS: Do not increase inflammation
*VISITS: 1 time per wee (max) or 1 time every other week
C. Scapular stabilizing exercises.
Stage III (7-12 weeks)
A. AROM for all exercises
1. Begin with 2 oz. Weights and increase to 1 lb. Weight
2. Patient should experience only minimal pain with exercises or occuring later in day.
B. Scapular stablizing exercises.
* GOAL: Full AROM by week 12
*PRECAUTION: Do not increase inflammation or overwork cuff. 4 oz. Weight limit until week 8; then progress as tolerated.
*VISITS: 2 maximum over these 6 weeks. Emphasis is on home program.
Stage IV (13-24 weeks)
A. Progress on rotator cuff exercises with no weight limit. Emphasis is on home program
B. Scapular stabilizing exercises
*GOAL: Return to work and sports without limits 4-6 monts post-op. Full AROM to pre-set limits.
Home Program: 7 days/week for stretching/ice. 4 days/week for strengthening
*VISITS: 1 time every other week only if patient is progressing slowly. (Maximum 3 visits)
THIS PROTOCOL PROVIDES GENERAL GUIDELINES FOR THE REHABILITATION OF ROTATOR CUFF REPAIR SHOULDER PATIENTS. SPECIFIC CHANGES IN THE PROGRAM WILL BE MADE BY THE PHYSICIAN AS APPROPRIATE FOR THE INDIVIDUAL PATIENT. IF YOU HAVE ANY QUESTIONS REGARDING THE PROGRESS OF THE PATIENT , OR THE PROTOCOL PLEASE CONTACT THE PHYSICIAN AT (202) 444-8766.