Reverse or inverse total shoulder arthroplasty (rTSA) is becoming a widely accepted surgical intervention. to analyze our web traffic. Van der Meijden OA, W. P . 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. endstream endobj 770 0 obj<>stream Some possible complications may include: The joint pain and weakness may not be relieved by the surgery. Once youre home, its important to keep the surgical area clean and dry. 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. Mass General Brigham's network of Harvard Medical School-affiliated experts leads the nation in sports medicine research, technology, and innovations. Its one of the most important parts of the shoulder. You may undergo blood tests or other diagnostic tests. Rotator cuff repair may be done while you're asleep under general anesthesia or while you're awake under local or regional anesthesia. Women's Orthopedic and Joint Disease Center, Anesthesiology, Perioperative and Pain Medicine. Connect with us. Brigham and Women's Hospital, Division of Rheumatology, Inflammation, and Immunity, nonsteroidal anti-inflammatory medications. /-BmN2'ux)>MxYLV#a$F]7W9.|EzuonDxH/?uXPoN,);? 1 Chung SW et al. It stabilizes the ball-and-socket joint of the shoulder and allows for normal shoulder mechanics. <> 833 0 obj <>/OCGs[835 0 R 836 0 R]>>/StructTreeRoot 164 0 R/Type/Catalog>> endobj 98 0 obj <> endobj 2783 0 obj <>stream Rotator cuff surgery may be done using an arthroscope. Aspirin or certain other pain medicines may increase the chance of bleeding. ajp5 A sterile bandage or dressing will be applied. Your provider will discuss this with you in advance. 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. You may not recover full range of motion in the shoulder joint. uuid:463caef0-aa5d-4b8f-bc94-142f9b3774d9 Damage may also happen slowly over time. L|5C[[ZW%pGY8JMe{+u'O=1m Rotator cuff degeneration and tears may also be caused by aging. (2016). endobj 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 collected, please refer to our Privacy Policy. Stay Informed. Take a pain reliever for soreness as recommended by your healthcare provider. If your rotator cuff is injured, you may need to repair it surgically. Connect with us. For more information about these cookies and the data 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) Acrobat Distiller 8.0.0 (Windows) Bone spurs will be removed if there are any. 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; x][~G[" $`u[6=nwgz~HH[6M} ^|jg4?/>=W6ugqAxi??='O71R +gA^V%w?h0J6 }l?x)?VQ,QK-XTS1aM 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. We use cookies and other tools to enhance your experience on our website and The rotator cuff may be damaged from a fall or other injury to the shoulder. endobj Your recovery process will vary depending on the type of anesthesia that is given and the type of surgery thats done. 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. Brigham and Womens Hospital is committed to providing all of our patients with the safest, highest-quality, most-satisfying care possible and following established protocols that have been shown to improve patient outcomes. 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. Learn about career opportunities, search for positions and apply for a job. ter rotator cuff repair is 30 of eleva-tion in the scapular plane, with 0 to An open repair may be performed if the rotator cuff injury cannot be repaired using arthroscopy. Generally, rotator cuff repair surgery follows this process: You'll be asked to remove clothing and given a gown to wear. An open repair may be done if the rotator cuff injury cant be repaired using arthroscopy. We pride ourselves in the quality of patient care we provide and how we compare with other hospitals. Once your blood pressure, pulse, and breathing are stable and you're alert, you'll be taken to your hospital room or discharged to your home. Continue to emphasize scapular stabilizers. As with any surgical procedure, complications can happen. This guideline is designed to 1 Oxford Road New Hartford, NY 13413. 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. Boston, HMn0F:N@_A"'( -P7Ul8 >qr5i>M___c*h?) Procedures may vary depending on your condition and your providers practices. 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. The circulation and sensation of your arm will be monitored. 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. % This information is not intended as a substitute for professional medical care. 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. to analyze our web traffic. 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. The conservative approach may be associated with post-operative stiffness which can be managed once healing has occurred. 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. 5. Shoulder injuries are common. Connect with us. SUBSCAPULARIS REPAIR REHABILITATION PROTOCOL ! Mass General - Boston <>/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>> Stay Informed. <> In older patients, there may not be an injury or event to cause the tear. 2000-2023 The StayWell Company, LLC. They should not be copied or otherwise used without the permission of the Director of Rehabilitation Services. 02114. It's one of the most important parts of the shoulder. vywh0*-)Ha[ %2+$t^> K5$*{c Z Q.@B[,4nr^{.zlqE@`Cu.> The rotator cuff may be damaged from a fall or other injury to the shoulder. 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. Mass General Brigham's Sports Medicine Program now offers urgent access virtual visits. We use cookies and other tools to enhance your experience on our website and An arthroscope is a small, tube-shaped instrument that is inserted into a joint. %PDF-1.6 % 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. The decelerated rehabilitation avoids excessive tension on the SS & IS by avoiding excessive scaption, ER, & FF until 4 weeks. You may get a medicine (sedative) before the procedure to help you relax. HWMo8W(oQ@QIECw^8++kJdGvqd7FWzj7,N.NlI~Kk6}b6}%O, Microsoft Word - Rotator cuff and SLAP patient info.doc. Always follow your healthcare professional's instructions. The rotator cuff is made up of muscles and tendons that hold the shoulder in place. It may be necessary for you to stop these medicines before the procedure. Find PDFs of our most common rehabilitation protocols. Surgical techniques that may be used to repair a tear of the rotator cuff include arthroscopy, open surgery, or a combination of both. stream Learn about the many ways you can get involved and support Mass General. 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. 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 <> endobj 2348 0 obj <> endobj 2349 0 obj <> endobj 2350 0 obj <> endobj 2351 0 obj <> endobj 2352 0 obj <> endobj 2353 0 obj <> endobj 2354 0 obj <> endobj 2355 0 obj <> endobj 2369 0 obj <> endobj 2372 0 obj <> endobj 2373 0 obj <> endobj 2374 0 obj <> endobj 2381 0 obj <> endobj 2382 0 obj <> endobj 2383 0 obj <> endobj 2384 0 obj <> endobj 2385 0 obj <> endobj 2386 0 obj <> endobj 2560 0 obj <> endobj 2392 0 obj <> endobj 2399 0 obj <> endobj 2400 0 obj <> endobj 2459 0 obj <> endobj 169 0 obj <> endobj 2403 0 obj <> endobj 2404 0 obj <> endobj 2405 0 obj <> endobj 2406 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2359 0 obj <> endobj 190 0 obj [820 0 R] endobj 191 0 obj [821 0 R] endobj 192 0 obj [822 0 R] endobj 193 0 obj [823 0 R] endobj 195 0 obj [825 0 R] endobj 196 0 obj [816 0 R] endobj 197 0 obj <>]/P 717 0 R/S/Link/Pg 21 0 R>> endobj 199 0 obj <>]/P 534 0 R/S/Link/Pg 32 0 R>> endobj 200 0 obj [533 0 R] endobj 201 0 obj [529 0 R] endobj 2255 0 obj <> endobj 2257 0 obj <> endobj 2259 0 obj <> endobj 2261 0 obj <> endobj 2263 0 obj <> endobj 2265 0 obj <> endobj 2267 0 obj <> endobj 2269 0 obj <> endobj 2271 0 obj <> endobj 2273 0 obj <> endobj 2275 0 obj <> endobj 2277 0 obj <> endobj 2279 0 obj <> endobj 2281 0 obj <> endobj 2283 0 obj <> endobj 2285 0 obj <> endobj 2287 0 obj <> endobj 2289 0 obj <> endobj 2291 0 obj <> endobj 2293 0 obj <> endobj 2295 0 obj <> endobj 2297 0 obj <> endobj 2299 0 obj <> endobj 2301 0 obj <> endobj 2303 0 obj <> endobj 2305 0 obj <> endobj 2307 0 obj <> endobj 2309 0 obj <> endobj 2311 0 obj <> endobj 2313 0 obj <> endobj 2318 0 obj <> endobj 2316 0 obj <> endobj 2323 0 obj <> endobj 2328 0 obj <> endobj 2333 0 obj <> endobj 2338 0 obj <> endobj 2336 0 obj <> endobj 2343 0 obj <> endobj 2344 0 obj <> endobj 2341 0 obj <> endobj 1026 0 obj <>/ColorSpace<>/Font<>/ProcSet[/PDF/Text/ImageC]/ExtGState<>>>/Type/Page>> endobj 1109 0 obj <> endobj 1041 0 obj <>stream The arthroscope (if used) will be put through the incision. 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 use a comprehensive approach to caring for the whole athlete, treating your sports injury and helping you return to the activities you love. The conservative rehabilitation protocol allows Sharpey fibers to form before stressing the repair with resistive exercises. Because the sedative may make you drowsy, you'll need to arrange for someone to drive you home. Tell your provider about all prescription and over-the-counter medicines and herbal supplements that you're taking. to analyze our web traffic. Journal of Shoulder and Elbow Surgery, 4:521-535. If you believe you should have an evaluation and would like to schedule an appointment with one of our orthopaedic surgeons for rotator cuff surgery, knee replacement surgery or hip replacement surgery, call 1-800-294-9999 to speak to one of our knowledgeable coordinators who can help to connect you to the doctor that best meets your needs, or fill out an online appointment request form. LL`}*Tg/#VA|5RQSVt*#bH|5 [oB]bPY) 1ULXv$6*jthb Ylv An arm sling is used for 4 weeks post-op. endobj Pre-op. 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. mqTdYqc#\*DgVx?,a6&&tO"TP_YV{zYNm[ Dj?mk^(^N7K1_Q P ? +!B8p+*.QnMXNjtt ntr>&TZt`3o6?=^_.9|0dd\H c9{+'+::A{NhV{. If medical treatments aren't working, rotator cuff repair surgery may be an effective treatment. 85 College Street Hamilton, NY 13346. Brigham and Women's Faulkner Hospital Rehabilitation Services1153 Centre Street, 2nd FloorBoston, MA 02130. For very large tears, physical therapy may be delayed to promote rotator cuff healing up to 6 weeks postoperatively. `6B3}"{PT(3 _x g"8. The shoulder is a ball-and-socket joint: the head of the humerus (upper arm bone) fits into a socket in the shoulder blade. Call 617-643-3333 if youre experiencing a sports injury. 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. The anesthesiologist or nurse anesthetist will continuously monitor your heart rate, blood pressure, breathing, and blood oxygen level during the surgery. For over a century, a leader in patient care, medical education and research, with expertise in virtually every specialty of medicine and surgery. application/pdf . Search for condition information or for a specific treatment program. 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. 2012-04-12T06:10:33-04:00 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. 4 0 obj When one or more of the tendons in the rotator cuff is torn, it no longer fully attaches to the head of the humerus. Numerous rehabilitation protocols for the management of rotator cuff disease are based primarily on . In some cases, a tendon graft or joint replacement may be needed. Most commonly, however, this group of muscles co-contracts and . MA We offer diagnostic and treatment options for common and complex medical conditions. 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 rotator cuff consists of four muscles that come together as tendons to cover the head of the humerus.
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