Protocols

PHYSIOTHERAPY PROTOCOLS

ACCELERATED PROTOCOL FOR ROTATOR CUFF REPAIR

Assess for scapula dyskinesis and teach scapula setting.

Patient supplied with Ultrasling II SAS 15° abduction wedge brace.

Wedge brace to be worn 24 hours/day for 5 weeks. Rolled towel under armpit or similar waterproof
wedge to replace abduction wedge when showering.

The most comfortable sleeping position is supine with a pillow behind elbow and brace, supporting
arm forwards into neutral (ie: avoiding shoulder extension).

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TOTAL SHOULDER REPLACEMENT

Deltopectoral or Anterior Surgical Approach

Normally most of subscapularis will have been detached and resutured so this needs protecting by:-

    1. No combined abduction with external rotation for 6 weeks.
    1. No active medial rotation for 5 weeks. No resisted medial rotation for 6 weeks
  1. Limit external rotation to MAX 20° for 4 weeks, 40° for 6 weeks. Avoid all sharp pain.

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ANTERIOR STABILISATION

 

No external rotation for 4 weeks. No combined full abduction with external rotation for 12 weeks. Avoid sharp pain throughout.

 

Weeks 1, 2, 3 and 4

  • Keep sling on at all times except for washing and dressing.
  • Active wrist flexion/extension.
  • Active elbow flexion/extension – except in the case of SLAP/biceps repair, in which case passive elbow flexion/extension only until 5 weeks.

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ROTATOR CUFF REPAIR

Assess for scapula dyskinesis and teach scapula setting.

Patient supplied with Ultrasling II SAS 15° or 40° abduction wedge (determined at surgery).

 

Wedge brace to be worn 24 hours/day for 6 weeks. Rolled towel or similar waterproof wedge to replace abduction wedge when showering.

 

Read More…
Download the PDF