Rotator Cuff Repair

Mini-open / Arthroscopic + arthroscopic sub-acromial decompression

 

On Ward:

  • Sling for 4-6/52.
  • Day 1 on ward. Physiotherapist to start passive and gentle active-assisted (dependant on post-op instructions) external rotation to neutral, elevation in internal rotation to 90° as pain allows.
  • Maintenance elbow, wrist, hand and neck exercises (this may be taught to relative as appropriate).
  • Posture and scapula setting.
  • Washing techniques and sling advice/management.
  • Review by clinical specialist at ~2/52 post-op in clinical specialist shoulder clinic at RSH, to be booked before discharged by ward staff.

2-6 weeks:

  • As control and pain allows progress assisted elevation into neutral, <4/52 0-90° then progress>90°
  • Early neutral isometric cuff work may be advised after 3/52 dependent upon repair done
  • Outpatient physiotherapy may increase joint range with passive and active-assisted techniques after 4/52. If the joint is becoming tight, accessory mobilisations and soft tissue techniques can be applied.
  • Milestone at 6 weeks: Active assisted ROM equal to pre-op level as pain allows.

6 weeks +:

  • > 6/52progress to full ROM actively if pain allows.
  • 6-12/52. Active/light resistance cuff retraining through range and full function
  • >12/52. Full power of cuff through range and functional rehabilitation to include proprioceptive training.
    Ensure good quality scapulo:humeral movement patterns through range
  • Patient has follow-up appointments in shoulder clinic at 6/52, 3/12 and 9/12.
 

Return to work: Sedentary 3-6 weeks (as pain allows). Physical 3-6 months (as pain allows).
Driving: 6 weeks (as pain and range allows) patient confirms they are able to drive safely.
Sport: Non contact 6 months. Contact: 9 months to 1 year
Swimming: Gentle with modified stroke 8-10 weeks. Freestyle 12-16 weeks