⇒ 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
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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 208–245Google 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
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
