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2 Therapeutic Exercise > Lecture 10, Rotator Cuff Repair > Flashcards

Lecture 10, Rotator Cuff Repair Flashcards

1
Q

Rotator cuff tears

A

may involve individual tendons or a combination of tendons
just this word alone is an insufficient info

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2
Q

Types of rotator cuff tears

A

chronic degenerative tear
acute avulsion tear

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3
Q

Chronic degenrative tear

A

usually >40 yrs old
Typically SIT
majority of tears is this kind
history of subacromial impingement and shoulder pain

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4
Q

Acute avulsion tears

A

acute subscap tears
younger patients
fall with hyperabduction/ER or dislocation

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5
Q

Iatrogenic Injuries

A

due to failure of surgical repair

relating to illness caused by medical exam or treatment

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6
Q

Tears are described by their….

A

thickness

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7
Q

Determinants of success of surgery

A

confidence in PT
activity level
age
smoking
size of tear (3cm or less have same outcomes)

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8
Q

Indications for surgery (rotator cuff)

A

pain –> years with no other options helping
impaired function
loss of strength

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9
Q

How to decide on type of surgery

A

thickness of tear
#of tendons involved
associated lesions
acuity
surgeon

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10
Q

Types of rotator cuff repairs

A

arthroscopic
mini-open
open

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11
Q

What happens during the surgery?

A

removing scar tissue
tendon to bone fixation
capsular tightening or labral repair

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12
Q

General Rehab Principles

A

immediate or early post-op motion of GH joint
gain control of scapula for stability
gradual restoration of muscular strength and endurance

NO active motion before 6 weeks

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13
Q

What factors will influence the progression of a patient post-op rotator cuff repair?

A

Onset of injury
size and location of tear
associated pathologies
preoperative strength and ROM
General health
history of steroid injections/previous RC surgery
preinjury activity level or goals
type of repair
patient compliance
surgeon

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14
Q

Onset of injury and post op

A

chronic impingement and degeneration = slower progression vs acute injury

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15
Q

Size and location of tear post-op

A

large and more tendons = slower

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16
Q

Associated pathologies and post op

A

more structures involved in procedure = longer immobilization, slower progression of exercise, more precautions

17
Q

Preoperative strength and ROM w/post-op

A

pre-existing weakness, atrophy of stabilizers & cuff, limited motion = slower progression

18
Q

General health & post op

A

poor health, hx of smoking, hx inflammatory disease = slower

19
Q

History of steroid injections

A

compromised bone and tendon tissue quality affects viability of repair = slower progression

20
Q

Pre-injury activity level or post-op goals

A

higher level of activity creates greater risk for reinjury = more extended and advanced post-op training program

21
Q

Type of repair & post op

A

tendon to tendon = slower vs tendon to bone

22
Q

Patient Compliance and post op

A

doing too much or too little can affect outcome

23
Q

Immobilization

A

Small = 1-2 weeks
Medium = 3-6 weeks
Massive = 6-8 weeks

24
Q

Maximum protection phase

A

3-8 weeks

PROM pain free range
supine position
AAROM to AROM in late phase
good posture in spine
isometrics week 6

25
Q

do NOT ____ to resistance more rapidly even if the patient has no _____

A

progress
pain

26
Q

Moderate protection phase

A

8-12 weeks

arom without compensation
multiple angle isometrics
endurance over strength
focus on ADLs first

27
Q

Minimum protection phase

A

begin at 12-16 weeks, may last up to 6 months

full function, gradual progression
task specific training

outcomes should be pain relief, ROM, strength, functional abilities

28
Q

Motion post-op precautions

A

only PASSIVE, non-assisted ROM in supine, 6-8 weeks

29
Q

Strengthening post-op precautions

A

no UE weight bearing activities for 6 weeks
No resistance exercises for 6-8 weeks
know which tendon was repaired, progress ER and/or IR w/caution

30
Q

Stretching post-op precautions

A

no vigorous stretching for 6-12 weeks
know which tendon was repaired
avoid end range stretching

2 Therapeutic Exercise (14 decks)

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