If bright red blood soaks through the dressings, please . Progression through the protocol should be based . Shoulder Arthroscopy. Posterior Labral Repair Rehabilitation Protocol Remove the sling on the first day after surgery. Chest or shoulder deep water running GOAL • Normal strength WEEKS 6 - 8 . Rehabilitation Protocol for Arthroscopic Anterior Capsulolabral Repair of the Shoulder - Bankart Repair Rehabilitation Guidelines: Summary Table Post -op Phase/Goals Range of Motion Therapeutic Exercise Precautions Phase I 0 - 6 weeks after surgery Goals: Educate patient re: avoid stress on repaired tissue Protect anatomic repair The post-operative rehabilitation following arthroscopic rotator cuff repair begins pre-operatively when the shoulder surgeon explains to the patient the planned operative procedure, the peri-operative course and the demands of the post-operative rehabilitation. The severity. The protocol is divided into phases. Reduce them by doing them less often or less forcefully. 55(8): 850-858. This protocol is based on a review of the best available scientific studies Ice should be applied to the shoulder for 15-20 minutes following each exercise, therapy, or training session. Shoulder abduction (use caution-avoid increase in subacromial pain) c. Modified-empty can exercise, performed with thumb pointed up, (well below shoulder level) - limit patient's shoulder elevation below 60 - 70 degrees d. Prone external rotation e. Perform all above exercises without weights 10 repetitions, 1 - 2 times daily, progressing to 10 Side-lying external rotation. After an injury or surgery, an exercise conditioning program . Methods: Eighty patients with full-thickness supraspinatus tendon tears were randomly assigned to either supervised physiotherapy or home exercises only. Walk up exercise (active) Shoulder Forward Elevation (Active) C. Pain medication as needed every 4-6 hours. Day of surgery: Instructions Immediate Post-Op A. Improve range of motion of the shoulder and prevent adhesions from forming 2. General Shoulder Arthroscopy (Debridement, Subacromial Decompression, and/or Distal Clavicle Resection) 0-2 weeks post op Modalities as needed Sling until comfortable, or until follow up with doctor. Each phase is adaptable based on the individual and special circumstances. shoulder after arthroscopic surgery. Post Operative Arthroscopic Subacromial Decompression Protocol . arm with the shoulder blade. Full PDF Package Download Full PDF Package. Pre-op instructions (6:45) Post-op exercises (2.48) Post-op sling instructions (0:52) Videos to watch if you are preparing for: Physical Therapy. Methods: Sixty-four shoulders available for postoperative magnetic resonance imaging (MRI) evaluation after arthroscopic rotator cuff repair were enrolled in this study. Due to the large amount of fluid used during arthroscopy, it is normal to see some bloody drainage on the dressings. May remove for sleep and stretching/ROM exercises 2. Type 2 or 4 SLAP tear (biceps anchor detached) Failure of at least 12 weeks of non-operative treatment, including activity modification/avoidance of painful activities AND at least one of the . SHOULDER ARTHROSCOPY WITH BICEPS TENODESIS REHAB PROTOCOL AND POST-OP INSTRUCTIONS . 2 • Theraband ex x 4 - Gradually increase resistance . All times and exercises are to serve as guidelines. Weight. May remove for sleep and stretching/ROM exercises Most patients are fully out of sling by 1-2 weeks post op Shoulder Arthroscopy, Decompression, and Biceps Tenodesis Day of Surgery A. Sling Use your sling as needed for comfort. A short summary of this paper. 2010 Apr;40(4):230-7 3. performing daily exercises to ensure there is proper return of range of motion and strength. Contact Ohio State Sports Medicine at 614-293-2385 if questions arise Phase I - Initial Exercise Goals • Protect integrity of repaired tissue • Restore ROM within restrictions Begin the pendulum exercise several times a day: Pendulum exercise This Paper. Talk to your doctor or physical therapist about which exercises will best help you meet your rehabilitation goals. You may remove the sling for exercises as prescribed by the surgeon/therapist, icing, dressing, and showering. HIP ARTHROSCOPY CLINICAL PRACTICE GUIDELINE Progression is time and criterion-based, dependent on soft tissue healing, patient demographics and clinician evaluation. You can change the dressing to a smaller one to allow the cold therapy to reach the s houlder. Sports Medicine, Shoulder Surgery and Cartilage Restoration UCLA Department of Orthopaedic Surgery David Geffen School of Medicine at UCLA 10833 Le Conte Avenue, 76-143 CHS Los Angeles, CA 90095-6902 Phone: (310) 825-6095 Fax: (310) 825-1311 CA License: A126262 SHOULDER ARTHROSCOPY PHYSICAL THERAPY PRESCRIPTION progress. Mathes Shoulder Pendular Swing Exercises Spend about 15 minutes, 3 times a day exercising your shoulder. If you can do this without hiking the shoulder blade, do ten . General Shoulder Arthroscopy (Debridement, Subacromial Decompression, and/or Distal Clavicle Resection) Post-operative Rehabilitation Protocol 0-2 weeks post op § Modalities as needed § Sling until comfortable, or until follow up with doctor. Long JL, Ruberte Theile RA, Skendzel JG, et al. All times and exercises are to serve as guidelines. Use of the operated arm rotator cuff repair. Epub 2010 Jan 15- Jost B, Zumstein M, Pfirrmann CW, Gerber C. Longterm outcome after structural failure of rotator cuff repairs. Return to sport is based on provider team (physician, physician assistant, athletic trainer, therapist) input and appropriate testing. - Isometric scapular stabilization. Stage 1: Begin at 3 weeks. Return to sport is based on provider team (physician, physician assistant, athletic trainer, therapist) input and appropriate testing. EXERCISES: EXERCISES: Active assisted motion (AAROM) supine with wand Full pendulum exercises - Flexion and Abduction to 90 degrees - degrees as toleratedER to within 50% of opposite shoulder AROM - IR (supine, abd to 45 degrees) to within 30 degrees of opp shoulder degrees 1-2 Finger Isometrics x 6 (fist in box) To ensure that this program is safe and effective for you, it should be performed under your doctor's supervision. These should be left in place for 3 days. Arthroscopy. The procedure usually takes less than an hour. elbow/wrist exercises Begin shoulder PROM all planes to tolerance /do not force any painful motion follow-ups Day 1, 4 weeks, 3 months, 6 months and 1 year. Refer to MS-19: Shoulder for advanced imaging indications for conditions of the shoulder. You can change the dressing to a smaller one to allow the cold therapy to reach the shoulder. 1. shoulder arthroscopy. If the pain is still worse, see the physiotherapist . D. You may remove arm sling as tolerated and begin gentle range of motion (pendulum exercises) two to three 2 (5): 424-432. Prevent shoulder stiffness 2, Regain range of motion 3. Read this blog to know about the Stability and exercises after a shoulder dislocation Surgery. Ok to shower, keeping shoulder covered and as dry as possible with saran wrap and tape c. Pre-op instructions (6:45) Post-op exercises (2.48) Post-op sling instructions (0:52) Videos to watch if you are preparing for: ‐ Initiate shoulder isometrics and scapulothoracic re‐education and stabilization ‐ Control inflammation and pain Phase II (weeks 2-6) Intermediate phase Weeks 2-4 ‐ Continue with ROM exercises (PROM/AAROM/AROM) ‐ Use of pool therapy if possible for ROM and shoulder strengthening • Surgery. Ice should be applied to the shoulder for 15-20 minutes following each exercise, therapy, or training session. rehabilitation guidelines for Shoulder arthroscopy posttraumatic degenerative disease of the AC joint and shoulder impingement syndrome.4 Chronic impingement and/or inflammation of the long head of the biceps (Figure 1) can also be a pain generator in the shoulder. Control pain and inflammation 2. After your recovery, these exercises can be continued as a maintenance program for lifelong protection and health of your shoulders. Shoulder Arthroscopy Subacromial Decompression & Distal Clavicle Excision Frank B. Norberg, MD Ryan Nelson MPAS PA-C Office: (952) 456-7000 Post-op appointments: 1 WEEK, 5 WEEKS, 10 WEEKS, 16 WEEKS PHASE I (WEEKS 0-4) Immobilization: • 1-2 WEEKS as needed: Sling should be worn continuously for at least 1 day and should Initiate muscle contraction The rehabilitation program will gradually progress to more strengthening and control type exercises. Follow-up appointments you should have scheduled: • You will have your first post- . clavicle fracture fixation. Initially patients may use a sling for comfort. After arthroscopic examination of the shoulder (i.e., diag - nostic arthroscopy), the ASD procedure that involved the debridement of the entire subacromial bursa (bursec-tomy) and resection of the bony spurs and the projecting anterolateral undersurface of the acromion, was carried out with a shaver, burr and/or electrocoagulation [14]. Exercises to strengthen the shoulder may help to prevent a recurrence. Length of program: This shoulder conditioning program should be continued for 4 to 6 weeks, unless otherwise specified by your doctor or physical therapist. BICEP TENODESIS PROTOCOL Weeks 1-2 Full time in sling to minimize biceps activity and avoid shoulder extension at night when supine. 5. Progression through the protocol should be based . Icing is important for the first 5-7 days post-op. total shoulder arthroplasty/proximal humerus fracture fixation. After arthroscopic examination of the shoulder (that is, diagnostic arthroscopy), the ASD procedure, which involved the debridement of the entire subacromial bursa (bursectomy) and resection of the bony spurs and the projecting anterolateral undersurface of the acromion, was carried out with a shaver, burr, and/or electrocoagulation. Remove the sling on the first day after surgery. M.D. • Move your elbow, fingers and hand several times a day. SHOULDER ARTHROSCOPY WITH BICEPS TENOTOMY 1. . Decrease in joint volume as a result of fibrosis and hyperplasia of the joint capsule leads to . 3. Continue this exercise from phase one using a one or two pound . • Continue appropriate previous exercises . Active shoulder mobilization was started after 6 weeks and strengthening exercises were started after 3 months. Relax. labral repair/ shoulder stabilization. J Orthop Sports Phys Ther. • Pendulum Exercises Strength • Scapular stabilization (scapular clock and manual resisted scapular PNF patterns) • Submaximal isometrics in neutral for shoulder and elbow- no elbow flexion Goals to Progress to Next Phase 1. Promote healing of tissue 4. Repeat 5-10 times per session. . • Rest your good arm on the edge of the table Maintenance of good postural positioning when performing all exercises. Returning to Sports General Principals. 37 Full PDFs related to this paper. Begin shoulder PROM all planes to tolerance /do not force any painful motion Scapular retraction and clock exercises for scapula mobility progressed to scapular isometric exercises Ball squeezes Sleep with sling as needed supporting operative shoulder, place a towel under the elbow to prevent shoulder hyperextension It is designed for rehabilitation following Shoulder Arthroscopic Labral debridement. to guide the shoulder surgeon and therapist, but there remains an art to the process. Do 10 repetitions to 90 degrees. While the post-op dressing is in place, icing should be done continuously. Immediately post-operatively, exercises must be modified so as not to place The arthroscopic decompression procedure is normally the result of clinical diagnosis of shoulder impingement syndrome. Rest your good arm on the edge of the table Hughes, M, Neer II, CS. Gradual increase in ROM 3. Although it seems clear that it conditions patient comfort and satisfaction, controlling pain is a prerequisite for an outpatient practice, which is tending to be generalized in all centers specialized in shoulder arthroscopy. There was no recall of any specific injury pre-cipitating the start of the symptoms. Remove sling for exercises. General time clavicle fracture fixation. The shoulder is a wonderfully complex joint that is made up of the ball and socket connection between . Shoulder Arthroscopy - Postoperative Instructions • Dressing: After surgery, the wound is covered with gauze pads and tape. Pulley exercises Hang your pulleys over a door and face the door. GALLAND/KIRBY ANKLE ARTHROSCOPY POST-SURGICAL REHABILITATION PROTOCOL POST-OP DAYS 1 - 10 . The aim of this randomized controlled trial was to assess the effectiveness of supervised physiotherapy after arthroscopic rotator cuff reconstruction. Arthroscopic Rotator Cuff (ARC) Clinical Trial ROTATOR CUFF HOME EXERCISE PROGRAM TABLE OF CONTENTS General Instructions 1 Passive Motion Exercises 2 Active Assisted Range of Motion Exercises 3 Active Range of Motion Exercises 6 Isometric Exercises 8 Resisted Exercises 9 Rotator Cuff Strengthening Exercises 11 Shoulder Stretches 13 shoulder arthroscopy. Sling Your sling is not necessary except for comfort, unless Dr. Gill instructs you to continue using it (use it for comfort . After that, keep the sling on while out and about or unless clinically indicated. Shoulder Arthroscopic Labral Debridement Rehabilitation Guideline This rehabilitation program is designed to return the individual to their activities as quickly and safely as possible. 3— Shoulder Arthroscopy Clinical Tip Sheet Shoulder Labral Repair - SLAP, ankart, apsulorrhaphy (includes distal clavicle excision, synovectomy, decompression, tenodesis/tenotomy and debridement). Sports Health. Shoulder Arthroscopic Capsular Release Rehabilitation Phase one: 0 to 4 weeks after surgery Goals: 1. The general treatment for a variety of shoulder procedures involves protection of the repair, stretching/mobilizing tight or restricted structures, strengthening the rotator cuff and Ice pack to shoulder every 1 to 2 hours, while awake, for 20 minutes. • Improve neuromuscular control of shoulder complex Exercises: • Initiate isotonic program with dumbbells • Strengthen shoulder musculature- isometric, isotonic, Proprioceptive Neuromuscular Facilitation (PNF) Hold for 10-20 seconds. Diet as tolerated. One hundred eighty-four patients in a randomised trial had undergone arthroscopic subacromial decompression (n = 57), diagnostic arthroscopy, a placebo surgical intervention, (n = 59), or exercise therapy (n = 68).We assessed return to work, defined as having returned to work for at least two follow-up visits by the primary 24-month time point, work status at 24 and 60 months, and . - Pendulum exercises 3 times a day. Arthroscopic biceps tenotomy protocol This protocol provides the therapists with a general guideline for patients after this type of procedure. Many people can go back to work or school in a few days. Suggested shoulder exercises categorized by time of initiation and phase of postoperative rotator cuff rehabilitation. Aerobic conditioning throughout the rehabilitation process. Rehabilitation After Arthroscopic SLAP Repair 333 38th St. New York, NY 10016 (646) 501 7047 newyorkortho.com Goals o Protection of shoulder after surgery o Activate muscles that help stabilize your glenohumeral and scapulo-thoracic joints Precautions o Sling immobilization at all times except for showering and rehabilitation under guidance of physical therapist 2. B. Activation of the shoulder musculature during pendulum exercises and light activities. Apply ice to the shoulder as tolerated to reduce pain and swelling. elbow to avoid shoulder hyperextension / anterior capsule stretch. Shoulder labral tear exercises pdf The superior glenoid labrum of the shoulder is a common site of injury and degeneration, which can cause both pain and disability.1 2 Snyder et al1 used the term SLAP (superior labrum anterior posterior) to describe a combined detachment of the long head of biceps tendon and the superior labrum from the glenoid rim ( 1figure). *Patient must be able to elevate arm without shoulder or scapular hiking before initiating isotonics; if unable, continue glenohumeral joint exercises WEEK 12: • Continue all exercise listed above • Initiate light functional activities WEEK 14: • Continue all exercise listed above • Progress to fundamental shoulder exercises 2 Weeks 2 to 3 Exercise •Initiate isotonic strengthening program (no weight) • Shoulder elevation • Prone rowing • Prone horizontal abduction • Prone shoulder extension to neutral • Sidelying external rotation • Sidelying abduction to 90 degrees •After one week of performing exercises with no pain and proper form, progress to one pound weight . Do 3 sessions a day. Pendulum exercises were started on the second day after the 160 www.cisejournal.org operation. Apply ice to the shoulder as tolerated to reduce pain and swelling. 1975. Shoulder Arthroscopy: A Guide to Recovery After Surgery www.rebalancemd.com • 104 - 3551 Blanshard St. Victoria BC V8Z 0B9 • tel 250 940 4444 • fax 250 385 9600 Page 5 April 2015 v1/S. Methods. Each patient's surgery and postoperative progress may be different, and this protocol . The determination of medical necessity for the performance of shoulder surgery is always made on a case-by-case basis. Introduction. • Active distal extremity exercise (Elbow, Wrist, Hand) • Pendulums • Frequent cryotherapy for pain, swelling and inflammation management • Patient education regarding proper positioning & joint protection techniques Postoperative Days # 2-10 (out of hospital) • Continue above exercises Once the dressing is removed on the first or second day, ice is applied for 20-minute periods 3-4 times per day. Shoulder internal rotation (assisted) Walk Up Exercise (Active) With elbow straight, use fingers to "crawl" up a wall or door frame as far as possible. Use the good arm to raise the Diet: as tolerated B. Shoulder . Move your elbow, fingers and hand several times a day. SHOULDER RANGE OF MOTION EXERCISES Johns Hopkins Division of Shoulder Surgery Department of Orthopaedic Surgery Created 9/26/2017 Edward G. McFarland, MD Jorge L. Rojas, MD Marcy Beard, PA Introduction: These exercises are recommended by us for you to perform on your own to regain your shoulder range of motion. Shoulder Arthroscopy: A Guide to Recovery After Surgery www.rebalancemd.com • 104 - 3551 Blanshard St. Victoria BC V8Z 0B9 • tel 250 940 4444 • fax 250 385 9600 Page 6 June 2017 v1/S. Shoulder Arthroscopy with Rotator Cuff Repair Surgery Guide. repetitions fully overhead. Continue with the exercises which feel different on the problematic shoulder, aiming to try and get rid of the difference between the two arms. Home Exercise Program after Reverse Total Shoulder Arthroplasty Most patients using a home exercise program should perform their exercises 3-4 times per day, performing three sets of ten repetitions. 6. whether the procedure is open or arthroscopic all patients will likely be home on the same day as surgery. Shoulder arthroscopy is considered as a minimally invasive technique and popular in clinic treatment for its small trauma, fast postoperative recovery and safety (Paxton et al., 2013). 2010 Mar;26(3):393403. Initially patients may use a sling for comfort. Read Paper. labral repair/ shoulder stabilization. 14 raise the arm by hinging at the shoulder as opposed to raising the . Do the exercises regularly 1-2 times a day. Following an arthroscopic decompression, the patient should avoid overhead activities for up 515 Ray C. Hunt Drive, Suite 1100, Charlottesville, VA 22903 Phone: 434-243-7778 Fax: 434-243-5075 . Shoulder arthroscopy is a minimally invasive surgery to treat shoulder problems, including shoulder impingement and rotator cuff tears. Arthroscopic Bankart Repair Rehab Protocol This rehabilitation protocol has been developed for the patient following an arthroscopic Bankart surgical procedure. rotator cuff repair. Glenohumeral joint replacement and postoperative rehabilitation. 2010. - Elbow and wrist AROM 3 times a day. Surgery may be required to treat shoulder tendinitis and bursitis if it becomes chronic or if there is a tear of the rotator cuff. Sling at all times except for showering and for exercises as directed below. 2016% Andrew%Cuff,%Specialist%Musculoskeletal%Physiotherapist% % Mr.NickFerran,ConsultantShoulder&ElbowSurgeon % % REHABPROTOCOL& % Arthroscopic*Capsular*Release* Remove the sling and move the arm frequently by doing pendulum exercises. Frozen shoulder is a very common condition with a prevalence of 2%-5% in the general population. 10 repetitions. The question of postoperative pain after shoulder arthroscopy is essential. total shoulder arthroplasty/proximal humerus fracture fixation. Reinold MM, Gill TJ, Wilk KE, Andrews JR. Current concepts in the evaluation and treatment of the shoulder in overhead throwing athletes, part 2: Indications and Non-Indications Shoulder arthroscopic or open surgical procedures may be considered medically No heavy lifting of objects (no heavier than coffee cup) No supporting of body weight by hand on involved side No sudden jerking motions Performing the exercises two to three days a week will Ensure wound healing Activities: 1. Begin the pendulum exercise several times a day: Pendulum exercise Each phase is adaptable based on the individual and special circumstances. Shoulder arthroscopy rehab protocol Download PDF .Use of a sling for 1-2 weeks post-op unless otherwise indicated. sive shoulder pain with activity. The protocol is divided into phases. An electromyographic evaluation of subdividing active-assistive shoulder elevation exercises. Purpose: To compare range of motion and healing rates between 2 different rehabilitation protocols after arthroscopic single-row repair for full-thickness rotator cuff tear. The patient was given a shoulder brace to be worn in 15o abduction and 10o external rotation. Begin gentle strengthening Activities 1. The rehabilitation program will gradually progress to more strengthening and control type exercises. Do not continue with them if the pain worsens. UVA SPORTS MEDICINE . 2. Mathes Shoulder Pendular Swing Exercises Spend about 15 minutes, 3 times a day exercising your shoulder. unless doing the given exercises, until you are seen at your first post-op appointment. - No abduction and rotation combined movement until 4 weeks post-op Director, Shoulder Surgery The Steadman Clinic Vail, CO Arthroscopic Rotator Cuff Repair Protocol: The intent of this protocol is to provide the therapist and patient with guidelines for the post-operative rehabilitation course after arthroscopic rotator cuff repair. General time frames are Shoulder Arthroscopic Capsular Release Rehabilitation Phase One: O to 2 weeks after surgery Goals: I. The tendon can often become frayed or partially torn. 2. Your doctor may send you to a physical therapist for exercises or other therapy. During this time, range of motion exercises are started to prevent the shoulder from getting stiff and losing mobility. ARTHROSCOPIC ACROMIOPLASTY PROTOCOL WEEKS 0-2 Use a sling at all times, day and night. When the ball of the shoulder (called the head of the humerus) pops out of its socket (called the glenoid), instability occurs. The physiotherapist must exercise their best professional judgment to determine how to integrate this protocol into an appropriate treatment plan. As we know, a shoulder dislocation is very common among people who participate in sports activities. Rotator Cuff and Shoulder Rehabilitation Exercises. 1. In the presence of poor shoulder mechanics avoid repetitive shoulder AROM exercises/activity against gravity in standing. 3. b. During this time, range of motion exercises are started to prevent the shoulder from getting stiff and losing mobility. Two years prior to this evaluation, he had an arthroscopic subacromial decompres-sion (without distal clavicle resection) and posterior labral debridement due to increasing pain with exercise and daily shoulder after arthroscopic surgery. SHOULDER ROTATOR CUFF REPAIR POST-OPERATIVE GUIDELINES Phase 1: Recovery (Weeks 0-3) PRECAUTIONS • Avoid weight bearing on operative upper extremity • No shoulder active range of motion (AROM) • Avoid pain during ROM exercises • No shoulder external rotation (ER) past 0˚-30˚ depending on surgeon preference Educate patient on limited use of operative arm despite potential lack of or minimal pain complaints Arthroscopic Rotator Cuff Repair Protocol: .
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