Large Rotator Cuff Repair (Arthroscopic or Mini Open)

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Aims:                      

Repair tendon tears of 3-5cm

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Sling:                      

Up to 6 weeks. Wean out at 4-6 weeks.

Teach axilla hygiene and washing out of sling

 

Restrictions:          

Avoid active recruitment of supraspinatus against resistance for up to 4 weeks

Keep elbow at side for 3-4 weeks

Do not force or stretch for 8 weeks

 

0-3 weeks:             

Check neuro vascular status and operation note for variation

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:             

Remain in sling until 6 weeks unless stated in operation note

Gentle pendulum exercises-  small ROM

Continue exercise as 0-3 weeks

Isometric IR in inner range

Passive external rotation to neutral

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6-8 weeks:             

Wear sling for comfort

Gentle isometric cuff exercises

Gentle active elevation movements

Scapula setting into ROM

Add proprioception work as control improves

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8-12 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

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 1-3months

Manual jobs- may need to adjust activity for up to 4 months

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Driving:                

From 8 weeks dependant on pain and ROM