Considerations After Rotator Cuff RepairJuly 20, 2014 by admin
Special thanks to star physical therapist Leah Versteegen for providing this write up on a recent article from The Journal of Bone and Joint Surgery.
Shoulder rotator cuff repair aims to suture torn rotator cuff tendons and provide them with the optimal environment to heal and minimize chance of retear. Overall retear rates have decreased over the years, but are still a major concern. Better suture techniques have been thoroughly investigated but there is less attention paid to the rehabilitation protocol. Currently the gold standard for rehabilitation after surgery is to wear an abduction brace and begin physical therapy for passive range of motion within the first few weeks.
As surgical techniques have evolved from open surgery to arthroscopic surgery, there are questions as to whether this rehabilitation protocol is ideal. Animal studies have shown that longer periods of immobilization are beneficial to healing after rotator cuff repair.
A recent study published in The Journal of Bone and Joint Surgery investigated the effectiveness of immobilization after surgery in human subjects. The goal was to determine if longer periods of immobilization resulted in any clinical differences in outcomes, including shoulder range of motion, retear rates and clinical outcome scores. One hundred participants who met specific criteria and underwent arthroscopic repair of the rotator cuff were randomly sorted into two groups. One group was immobilized after surgery for 4 weeks, the other was immobilized for 8 weeks. After the allotted time of immobilization each participant underwent rehabilitation with a physical therapist that included passive range of motion then progressed to active range of motion and strengthening.
At the follow up conducted at 6 months and 24 months after surgery, there were no statistical differences between the groups with retear rates, passive range of motion or clinical scores. There were more reports of stiffness by participants who were immobilized for 8 weeks compared to those immobilized for 4 weeks. Patients were also less likely to adhere to the immobilization guidelines for a full 8 weeks compared to those immobilized for 4 weeks.
With no benefit in healing or diminished retear rate gained by immobilization for 8 weeks, it is deemed most beneficial to promote immobilization for 4 weeks after rotator cuff repair. The retear rate in this study was 10%, compared to previously reported rates of 20%-40% in studies that involved early passive range of motion before 4 weeks Thus a 4 week immobilization period may give the rotator cuff ample time to heal without increased stiffness and decrease retear rates.
Kyoung Hwan Koh, MD et al. Effect of Immobilization without Passive Exercise After Rotator Cuff Repair. In The Journal of Bone and Joint Surgery. March 2014. Vol. 96A. No. 6. PpE44 1-9.
Brent Dodge is the founding owner of Alpine Physical Therapy and is a board certified orthopedic specialist. He holds additional certifications in Functional Dry Needling, Manual Physical Therapy, and Strength and Conditioning.
All Alpine Physical Therapy Alpine Soccer Team Alpine Softball Alzheimer's Disease American Cancer Society Ana Soulia Angela Listug Vap Angela Listug-Vap Ankle Sprains Antara Quinones Aquatics Audrey Elias Back Pain Balance Biking Boston Marathon Brace Hayden Brent Dodge Cancer CDC Certified Chiropractic Climbing Concussion CoreAlign Core Studio Crossfit Dance Medicine Dennis McCrea Diabetes Diane Cummins Diva Day Dr. Liz Walker Eating Emily Jones Ergonomics Events Excercises Fall Prevention Fall Prevention Awareness Day Fishing Fitness Fit To Fight Foot Pain Functional Dry Needling Gary Gales Golf Good Food Store Headaches Health Her Health Hiking Hip Pain Jamie Terry Jeannette Kittredge Jessica Kehoe Jonathan Hoffman's Foundation Training Josie Sweeney Kayla Johnson Kerri Houck Knee Pain Kristi Moore Leah Versteegen Lindsy Campbell Linsey Olson Low Back Pain LYMPHEDEMA Mary Mischke Matt Schweitzer MISA Missoula Marathon Missoula's Choice Moms Montana Geriatric Society Morgan York Singer Morgan York-Singer MT Alpha Cycling National Cancer Institute National Falls Awareness Neck Pain Oncology Rehab Program Pain Pamela Pack Peak Health & Wellness Center Peak Triathlon Pelvic Pain Physical Therapy Physical Therapy (Journal) Pilates Primal Practice Relay For Life Resources Roger Sperry Ron Clijsen Ron Veilleux Runner's Edge Running Samantha Glaes Sam Schmidt Sarah McMillan Shoulder Pain Sitting Skiing Skye Folsom Soccer Spine Magazine Spine Rehab Sports STEADI (Stopping Elderly Accidents Tai Chi Tamarack Brewing Company Tara Mund The Runner's Clinic Tips Travis Dye Ultrasound Imaging University Of Montana Urinary Incontinence Walking Wellness Wellness Program Westside Dance Physical Therapy Who Is Perfect? Women's Health
Connect with us
Get to know us better. Our social media platforms are a great way to learn about our staff, upcoming events, newest technology, patient stories, and more.
who we are
Leading innovation in health and wellness for our community, delivering compassionate care, and inspiring through education.
Know what’s new. Plus, get a free consultation!
Copyright © 2017 Alpine Physical Therapy • All Rights Reserved
Site by Aesir Consulting
Site by Aesir Consulting