Medium Rotator Cuff Repair (Arthroscopic or Mini Open)

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Aims:                     

Repair tendon tears of 1-3cm

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Sling:                      

Up to 3 weeks. Wean out at 3-4 weeks.

Teach axilla hygiene and washing out of sling

May mobilise out of sling avoiding flexion/abduction as comfortable from day 1

 

Restrictions:          

Avoid active recruitment of supraspinatus against resistance for up to 3 weeks

Do not force or stretch for 6 weeks

 

0-3 weeks:             

Check neuro vascular status and operation note for variation

Gentle pendulum exercises-  small ROM

Shoulder shrugs

Elbow exercises- check op note for bicep surgery

Hand and wrist- full active movement inc supination and pronation         

Do not force or stretch

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3-6 weeks:             

Wean from sling 4- 6 weeks unless stated in operation note

Continue exercise as 0-3 weeks

Active assisted flexion/elevation prone or supine. NOT standing or sitting.

Passive external rotation to neutral

 

4-6 weeks:             

Isometric internal rotation

Scapula setting in neutral

Active assisted ROM in sitting position as pain and supraspinatus function allows

 

6-12 weeks:           

Flexion in prone and supine as much as possible

Gently increase ER and Abduction ROM actively as pain allows

Begin gentle strengthening exercise within available ROM

Check scapula control thorough ROM

Introduce proprioceptive exercises as control improves

Closed chain exercises

 

From 12 weeks:    

Push for full ROM

Progress with strengthening exercises within comfortable ROM

Continue proprioceptive work

 

Sports:                   

3 months- non contact sports, cycling, jogging, breast stroke

6 months- contact sports

9 months- overhead sports

 

Work:                     

Sedentary jobs- return as pain allows

Manual jobs- may need to adjust activity for up to 3 months

 

Driving:                 

From 8 weeks dependant on pain and ROM