Due to his self-confidence in the capability to repair the rotator cuff in a steady fashion, he has been comfortable pressing the rehabilitation program in ways that specifically protect the rotator cuff during the recovery period but allow range of motion and strengthening exercises to be carried out under the careful guidance of the knowledgeable rehab team at Clinics.
The reasoning behind extending and reinforcing the irritated rotator cuff in order to speed healing and practical efficiency is as follows: The irritated tissue is defined by increased fluid in between the cells, increased varieties of new members vessels, and inflammatory type cells. As a result of this inflammatory reaction, brand-new collagen tissue is laid down by the body in an effort to recover the injured tissue. If the shoulder is debilitated throughout this time, the brand-new collagen is set in a disorganized fashion, developing scar. The objective of gentle stretching, enhancing, and anti-inflammatory medication, is to promote the cells to put down collagen along the lines of tension, forming typical strong tendons. The combination of an excellent warm-up, mild extending, reinforcing below the limits of discomfort, icing after working out, and anti-inflammatory medication has been regularly shown to speed recovery time in the strongest possible fashion.
Recovery From Rotator Cuff Surgery at Home
Stretching of the shoulder rotator cuff muscles is easily performed both as treatment for inflammation and as a warm-up before activity. Specific stretches are targeted to the desired activity. For instance, for skiing, with a ski pole held firmly with one hand at the basket and one hand on the deal with, with the arms held out straight, bring the pole from the waist to above the head, repeating the motion gradually to the limits of the variety of motion. With the arms above the head, lean the ski pole as far as possible to the left and then to the right. This motion needs to be repeated with the arms in front of the body, both held out straight and in the flexed position. Lots of other shoulder stretches are available and the majority of are helpful as long as acute pain is avoided.
Strengthening of the shoulder rotator cuff muscles is finest performed by isolating each muscle group and selectively training that muscle. The subscapularis is the anterior stabilizer of the rotator cuff and responsible for internally rotating the shoulder. It is best reinforced by holding a hand weight in front of the body, with the arm flexed to 90º, and turning the hand to touch the belt. The exercise can be performed while resting on your back with the elbow close to your side and bent ninetyº. Lift the weight until it is pointing toward the ceiling then lower it gradually. The supraspinatus is enhanced by holding a lightweight (at first 3 – 5 lbs) out straight in front of the body, with the thumbs pointed toward the floor.
Gradually increase the weight to above the head. Stop if discomfort is produced in any part of this motion, as the rotator cuff is under maximal stress in this position. The infraspinatus is strengthened by holding the weight in the position of the ski pole simply prior to planting the pole. By turning the arm from the neutral straight ahead position, to the externally rotated (out to the side) position, the infraspinatus and teres minor are strengthened. Once again, this workout can also be carried out while lying on your side with the elbow near your hip, and bent 90º. Rotate the weight up until it is pointing towards the ceiling. Shoulder exercises are best performed with reasonably light weights and multiple repetitions.
List of Exercises After Rotator Cuff Surgery
- This method is a guideline only; real development will be based upon scientific discussion
- Early passive range of motion of the glenohumeral joint to prevent capsular adhesions is essential
- This early ROM is performed in a way that reduces the involved muscle: i.e., for supraspinatus, avoid adduction previous midline and external rotation
- Do not raise surgical arm above 70º in any plane for the very first 4 weeks post-op
- Do not lift any things over 5 pounds with the surgical arm for the first 6 weeks
- Prevent extreme reaching and external/internal rotation for the first 6 weeks
- Ice shoulder 3 – 5 times (15 minutes each time) daily to control swelling and swelling
- An arm sling is made use of for 4 weeks post-op. Sling wear during sleep is optional depending upon convenience
- Keep great upright shoulder girdle posture at all times– particularly throughout sling usage
- MD follow-up visits at Day 1, Day 14 nurse appointment for suture elimination, Month 1, Month 3, and Year 1 Post-op
- MD see Day 1 post-op to change dressing and examine home program
- Suture elimination at Day 14 post-op by nurse
- Exercises (3 times each day): 1) pendulum exercises, 2) squeeze ball, 3) triceps muscles and biceps training with Theraband, 4) pulley passive flexion and scaption (scapular airplane) 0-60º, 5) isometric shoulder abduction, adduction, extension, and flexion with arm at side, 6) scapular pinches every hour, and 7) neck stretches for convenience
- Clinic check out at 14 days for suture removal and check-up
- Use of strapping tape for secondary AC compression and support (optional).
- Soft-tissue treatments for associated shoulder and neck musculature for convenience.
- MD see at Week 4 post-op and will usually be advanced to a more aggressive ROM and stamina program.
- At Week 4: Start mid-range of movement (ROM) rotator cuff external and internal rotations and active and light resistance exercises (through 75 % of ROM as patient’s signs permit) without shoulder elevation and avoiding extreme end ROM.
- Strive for progressive gains to 90º of shoulder flexion and kidnapping.
- Seek gentle, complete shoulder ROM in all aircrafts– especially with flexion, abduction, external rotation, and internal rotation.
- Increase mobilizations of soft tissue as well as glenohumeral and scapulothoracic joints for ROM.
- Exercises: Wand exercises, ROM shoulder wheels, scapular training (rows, reaches, lower trapezius work, etc), and PNF.
- No overhead lifting.
After 3 months
- Start a more aggressive rotator cuff program as endured.
- Start progressive resistance exercises with weights as tolerated.
- Continue to seek full shoulder variety of movement in all planes.
- Increase the intensity of strength and practical training for progressive return to activities and sports.
- Return to specific sports is determined by the physiotherapist through practical screening specific to the targeted sport.
KEEP IN MIND: All progressions are approximations and must be used as a standard just. Development will be based upon specific patient presentation, which is evaluated throughout the treatment procedure.