Microsoft word - rehab_protocol4shoulder.doc

REHABILITATION PROTOCOL FOR SHOULDERS AFTER
ROTATOR CUFF REPAIR
Sling immobilization for six weeks (unless explicitly directed otherwise) 24 hours a day.
T-shirt to be worn with sling (NOT cut up the side) to protect skin in the axilla while in
the sling. A T-shirt is to be worn under Polar Care (cold ice pad) at al times to protect
the skin and prevent cold burns. To put on the t-shirt, bend forward at the waist, let arm
of operated shoulder hang down free, slide t-shirt into sleeve of that shoulder first, then
put t-shirt over head and final y through nonoperative/normal arm. Replace sling with
pil ow and strap around waist.
Take two (2) tablespoons of Metamucil one to two times per day while taking narcotic pain medications. May begin immediate range of motion (ROM) of fingers and wrist. May do grip strengthening with orange bal provided with the Ultra Sling. May begin elbow range of motion - active flexion and extension the day after surgery. While standing let arm come out of sling, bend and straighten elbow, one to two sets of 10 twice a day. Change bandage at home the second day after surgery. Band-aids to arthroscopy portals. May shower with waterproof band-aids two days after surgery and without any bandages four days after surgery. Shower at two to four days as directed above: Keep arm at side or across bel y to protect shoulder. To wash under operated arm, bend forward at the waist, let arm dangle freely, wash under arm with opposite/normal shoulder. Do NOT lift the operated arm to wash, dry, put clothes or sling on. NO ACTIVE MOTION of the OPERATED SHOULDER for SIX WEEKS! May use Polar Care (cold ice pad) or similar device as much as desired with t-shirt protecting the skin. Excel ent tool for pain control in the early (1st seven days) after surgery Usual y patients are more comfortable sleeping in a recliner or on a sofa or bed surrounded by pil ows and partial y sitting up the first couple of days after surgery. It is, however, fine to lie flat in bed if you are more comfortable that way. No anti-inflammatory medication (Motrin, Aleve, Naprosyn, Voltaren, Celebrex, etc) for four weeks after rotator cuff repair. Aspirin 325 mg one each day for 10 days starting on the evening of surgery to help prevent blood clots. REHABILITATION PROTOCOL
FOR SHOULDERS AFTER
ROTATOR CUFF REPAIR
PAGE 2
Long leg TED hose to be worn for three days fol owing surgery.
Fol ow up visit with surgeon at 10 to 12 days after surgery.
Bring in a family member to learn how to move the shoulder for the patient (passive range of motion ) in the scapular plane and pendulums.
Fol ow up visit with primary treating physician as scheduled by that office. - (Work
Comp patients only.)
Partial Articular Sided Tears (PASTA Lesion) start table slides at two to three weeks
after surgery.
Patients should not drive themselves for six weeks after surgery or until the sling is
removed. This is a MEDICAL/LEGAL issue.
Start massaging incisions once sutures have been removed.
Fol ow up visit three weeks later to assess range of motion.
Prescription written to start physical therapy at six weeks. Start strengthening at 10 to
12 weeks (dependent on the size of the tear and ease of repair at the time of surgery).
If range of motion is not going wel with family/friend assistance, start physical therapy
earlier with passive range of motion in the scapular plane until six weeks. Please notify
the office so this can be arranged for you.
Advance home exercise program at six weeks.
Lifting restrictions of one to two pounds. REHABILITATION PROTOCOL
FOR SHOULDERS AFTER
ROTATOR CUFF REPAIR
PAGE 3
16 weeks to 20 weeks
Michael A. Oberlander, M.D. John K. Merson, M.D. Bradley D. Crow, M.D.

Source: http://eastbaysportsmed.com/patient/forms/REHAB_PROTOCOL4SHOULDER.pdf