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Aug 23, 2005 11:34:39 (GMT -05:00) Eastern Time (US & Canada) Aug 23, 2005 00:00:00 (GMT -05:00) Eastern Time (US & Canada) No (click here to learn more about
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Script Details
SCRIPT
Lincoln Orthopedic Physical Therapy is all about helping people. Shoulder rehabilitation has always been an important emphasis of our practice.
There have been recent advances in early rotator cuff repair rehabilitation which we have added to our rehabilitation guidelines. Studies including those of Harrymund and Jost (jahst) report that a rotator cuff re-tear rate is between 25 and 35 percent.
The biomechanics of rotator cuff repair failure is increased tension on the cuff repair. Zuckerman (zuh-ker-man) and other authors report increased tension on the repair when positioned at zero degrees of abduction. This tension is eliminated at thirty degrees of abduction.
The key to protecting against rotator cuff re-tear is to protect against tension on the repair itself.
Important protection measures in early rehabilitation include, maintaining support of the arm in thirty degrees of abduction and avoiding the position of zero degrees, for four to six weeks, post op.
There should be a strong emphasis on patient education precautions including, no active elevation, avoiding positions of extension, and avoiding zero degrees of abduction.
Early exercise guidelines post operatively include passive range of motion exercises for the first six weeks.
Pendular (pen-duh-ler) exercises should be preformed in a relaxed fashion. Patients are taught to perform passive elevation cautiously, with good support, avoiding forcing into a painful range or stretching early in the rehabilitation.
Emphasis should be on relaxing and a controlled, pain free motion.
Return of external rotation and internal rotation should progress cautiously depending on the size and the location of the tear. The arm should be supported in thirty degrees of scaption and avoid overstretching for the first few weeks.
Sub maximal isometrics should start around four weeks and should be performed very easily in a position of thirty degrees of scaption avoiding the position of zero degrees of abduction so added stress is not placed on the repair.
Utilization of an overhead pulley for passive elevation can be an important exercise to improve elevation. The elbow bent position should be avoided as this creates a mechanical impingement. By using the elbow straight position we can avoid the mechanical impingement and enhance a more comfortable elevation.
As rehabilitation progresses into phase two and three with strengthening, care should be taken not to overload the cuff as you progress the strengthening exercises.
Incorporating these advances to early rotator cuff repair rehabilitation is part of our continued emphasis to protect the repair for the best possible outcome.
We appreciate the opportunity to serve you and your shoulder patients and we look forward to working with you in the future. Thank you for watching.
------- SCRIPT
Lincoln Orthopedic Physical Therapy is all about helping people. Shoulder rehabilitation has always been an important emphasis of our practice.
There have been recent advances in early rotator cuff repair rehabilitation which we have added to our rehabilitation guidelines. Studies including those of Harrymund and Jost (jahst) report that a rotator cuff re-tear rate is between 25 and 35 percent.
The biomechanics of rotator cuff repair failure is increased tension on the cuff repair. Zuckerman (zuh-ker-man) and other authors report increased tension on the repair when positioned at zero degrees of abduction. This tension is eliminated at thirty degrees of abduction.
The key to protecting against rotator cuff re-tear is to protect against tension on the repair itself.
Important protection measures in early rehabilitation include, maintaining support of the arm in thirty degrees of abduction and avoiding the position of zero degrees, for four to six weeks, post op.
There should be a strong emphasis on patient education precautions including, no active elevation, avoiding positions of extension, and avoiding zero degrees of abduction.
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