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Reference

Lädermann, Alexandre, Patrick J. Denard, and Philippe Collin. "Massive rotator cuff tears: definition and treatment." International orthopaedics (2015): 1-12. (2C)

Phase

Phase

: 18 to 26 weeks after surgery

:12-18 weeks after surgery

Days per week: 3 Times per day: 1

Activities:

Goal

Ski 6 months

Golf 6 months

Weight Training 6 months

Tennis 6 -8 months

Swimming 6 -8 months

Throwing 6 months

Goal

Exercise Program

Before returning safely to your activity, you must have full range of motion, full strength and no swelling or pain.

Exercise Program

Your doctor and sports physical therapist will provide you with specific instruction

Days per week: 3 Times per day: 1

Protect the rotator cuff repair

Jain, Nitin B., et al. "Clinical examination of the rotator cuff." PM&R 5.1 (2013): 45-56. (2A)

STRETCHING / ACTIVE MOTION / STRENGTHENING

Continue to protect the repair

(avoid lifting excessively heavy weights)

Days per week: 3 Times per day: 1

Theraband Strengthening

Stretching

Restore full shoulder motion

Dynamic Strengthening

Stretching ,Theraband Strengthening Dynamic Strengthening 은 이전 단계와 같은 운동들을 시행한다.

Regain full range of motion

External Rotation Internal Rotation Standing Forward Punch Shoulder Shrug Dynamic hug

“W”’s

Seated Row

Biceps curl

Restore full shoulder strength

이전 단계와 같은 운동들을 시행한다.

Plyometric Exercises

Continue gentle strengthening

Gradually begin to return to normal

activity

Your doctor or physical therapist will provide you with a specific plyometric-training program to follow when appropriate.

Dynamic Strengthening exercise can gradually be added!

Weight Training

See weight training precautions

starting with 1 Ib~ not exceed 3 Ib

AAOS, Rotator Cuff and Shoulder Conditioning Program

감사합니다

Rehabilitation

Rotator cuff injury protocol

Phase

: 6 to 12 weeks after surgery

: 0 to 6 weeks after surgery

Activities:

Activities:

1. Sling:

Your sling is no longer necessary unless your doctor instructs you to continue using it

1.Sling :

Use your sling most of the time. Remove the sling 4 or 5 times a day to do pendulum exercises.

Exercise Program

Goal

2. Use of the operated arm :

Exercise Program

2. Use of the affected arm :

You can lift your arm forward in front of your body but not to the side

Goal

*No Lifting of Objects

*No Excessive Shoulder Extension

*No Excessive Stretching or Sudden Movements

*No Supporting of Body Weight by Hands

Stretching

/ Active Motion

STRETCHING / PASSIVE MOTION

Days per week: 5-7 Times per day: 1-3

Days per Week: 7 Times per day: 4-5

Protect the rotator cuff repair

Protect the rotator cuff repair

Active Motion

stretching

Prone scaption “Y”

Supine Cross-Chest Stretch

Pendulum exercises

Ensure wound healing

Improve range of motion of the shoulder

Side-lying External Rotation

Wall slide Stretch

Active-Assisted Arm Elevation

Supine external Rotation with Abduction

Resisted forearm supination-pronation

Resisted wrist flexion-extension

Standing,supine external rotation

Prevent shoulder stiffness

Behind the back internal rotation

isometric exercises :

internal and external rotation at neutral with physical therapist

Supine passive arm elevation

Begin gentle strengthening

Regain range of motion

Shoulder shrug

symptoms

Diagnosis

X- rays

MRI

Clinical examination

•avoiding certain activities because they cause pain

•difficulty achieving full range of shoulder motion

•difficulty sleeping on the affected shoulder

•pain or tenderness when reaching overhead

•pain in the shoulder, especially at night

•progressive weakness of the shoulder

•trouble reaching behind the back

Rotator cuff test

Tests for subscapularis

Tests for Supraspinatus and Infraspinatus

Jobe’s test

Belly Press test

90 abduction

standing position

30 forward flexion

puts on hand stomach and push

Thumbs pointing downward

isometric contraction

Patient attempt elevation

shoulder position: Internal rotation

moves the elbow forward

- active and passive range of motion

- strength tests

- rotator cuff tests

Test for Teres minor

Tests for Supraspinatus and Infraspinatus

Hornblower’s Sign

external rotation lag test

shoulder and elbow 90 flexion

maintain maximal external rotation

hand comes to the mouth

+ : angular drop

+ : pain and inability maintain UE external rotation

Definition&Description

Cause

Rotator cuff injury

The most common injuries are strains, tendinitis, and bursitis.

the number of tendons which are torn

the size of the tear

Strain

Tendinitis

Bursitis

overuse

inflammation of the bursa

overuse

acute injury

muscles to bones can overstretch

Tennis players, who use an overhead serve

1. Small tear: less than 1 cm

2. Medium tear: 1–3 cm

3. Large tear: 3–5 cm

4. Massive tear: greater than 5 cm.

painters who have to reach upward to do their jobs

fall

car accident

another sudden injury

Anatomy

The rotator cuff exists of four muscles:

M. Subscapulairs

Internal rotation

M. Supraspinatus

GH Joint abduction

GH Joint stability

제공

M. Infraspiantus

External rotation

M. Teres Minor

Rotator Cuff Injury & Protocol

CONTENTS

1. Anatomy

2. Definition&Description

3. Cause

4. Symptoms

5. Diagnosis

6. Rehabilitation

7. Reference

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호남대학교 문선애

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