Phase1 (1~4weeks)

Goal

Exercise

inflammatory, proliferative & repair phase.

Protected tendon healing

PROM

Scapular realignment

 

1. Passive Rom

2. short-arm traction(IR/ER)

3. assisted forward flextion

4. scapular depression & protraction

(minimal posterior RC acivity)

5. pendulum(infra/supra MVIC 15%)

Avoided end range stretch (first 6 weeks), active exe

Avoided pulley exe

Avoided elevation from 30 to 60° (more 2 tendon injury, subscapularis injury)

 

Phase1 (1~4weeks)

collagen deposition and growth factors increase, with a peak increase around 10 days after surgery

repair should not be exposed to the excessive forces inposed by active motion

Pressure at the end range (stretching) should be avoided for the first 6 weeks

PROM is progressed with caution

 

Started periscapular activation

- isolated scapular depression, retraction performed and has shown to exhibit minimal posterior RC cuff activity

 

Approximately 20~30° of scapular plane

- preventing decreased blood flow in the supraspinatus

- increasing the subacromial space

 

PROM & Scpaular setting

reference

Myers, Joseph B. shoulder muscle reflex latencies under various levels of muscle contraction. Clinical Orthopaedics & Related Research. 407:92-101, February 2003.

Frederick A. Matsen, III, Caroline Chebli and Steven Lippitt. Principles for the Evaluation and Management of Shoulder Instability. J Bone Joint Surg Am. 2006;88:647-659.

Morrey BF, An KN (1990) Biomechanics of the shoulder. In: Rockwood CR, Matsen FA (ed) The shoulder. Saunders, Philadelphia, pp 208245Google Scholar.

Philip Mcclure, Lori A. Michener. Direct 3-dimensional measurement of scapular kinematics during dynamic movements in vivo. Published in Journal of shoulder and elbow surgery 2001

Parsons IM1, Apreleva M, Fu FH, Woo SL. The effect of rotator cuff tears on reaction forces at the glenohumeral joint. J Orthop Res. 2002 May;20(3):439-46.

MET

Young Jin Jo1, Young Kyun Kim. Consideration of Shoulder Injury Prevention and Rehabilitation Exercise for Overhead Sports Population. Asian J Kinesiol 2019; 21(2): 40-50 · DOI: https://doi.org/10.15758/ajk.2019.21.2.40

Ofer Levy, Hannan Mullett, The role of anterior deltoid reeducation in patients with massive irreparable degenerative rotator cuff tears. Medicine Published in Journal of shoulder and elbow surgery2005 DOI:10.1016/j.jse.2008.04.005

https://www.hep2go.com/index_b.php?userRef=120148

Olivier A. van der Meijden, MD1. Rehabilitation after arthroscopic rotator cuff repair: Current concepts review and evidence-based guidelines. International Journal of Sports Physical Therapy · April 2012

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