RC Repair & Adhesive Capsilites

Question 1

Goal for RC repair interventions

Answer 1

To return the pt. to I w/ ADL’s/IADL’s

Question 2

RC after repair

Answer 2

Sling/ABD wedge for 1-6 weeks depending on surgeon

Question 3

RC Intervention Weeks 1-3

Answer 3

Remove the sling for therapy after 1 week (?) of supervised PROM.
HEP of cervical, scapular depression-retraction w/ sh. at side and distal AROM.
Massage to scar site once healed.
Ex.: Pendulums, PROM in limited sh. planes.

Question 4

RC Intervention Weeks 4-6

Answer 4

AAROM w/ gravity eliminated for ABD/ER

Question 5

RC Intervention at 6 weeks

Answer 5

AROM

Question 6

RC intervention weeks 7-8

Answer 6

Light isometrics

Question 7

Adhesive Capsulitis Pathology

Answer 7

Many tissues are involves (bruse, glenohumeral capsule, biceps tendon, RC tendon).
Capsular thickening occurs in the anterior/inferior area.
Repair of tissues is delayed or impaired by frequent irritation, muscle atrophy.
Freezing (“itisi”), Frozen (thick), and thawing (x2years)

Question 8

Clinical signs of adhesive capsulitis

Answer 8

Onset between 50-70 years of age. Occurs in more woman then men, more frequently seen in sedetary workers and diabetics.
Develops slowly w/ pain and tenderness over the deltoid insertions (mostly tight in the anterior/inferior capsule)
Motion aggravates pain, decreased ADL’s & Sleep.
Shruging sh, motions.
Progresses to very decreased ROM and increased pain

Question 9

Adhesive capsulitis interventions

Answer 9

Guide in effective and efficeient fx. use
Prevent motion loss then restore fx. motion.
Do not increase pain.
Introduce adaptive equipment and sleep positioning (on back or side w/ body pillow w/ sh away from side).
Examine posture for muscle guarding.
AAROM, scapular clock, table slides.

Question 10

What are 4 of the EBP interventions for adhesive capsulitis & RC

Answer 10

1) Ex. was demonstrated to be effective in terms of short term recovery in RC disease & longer term benefit w/ respect to function.
2) Combining mobilization w/ ex, resulted in additional benefit when compared to ex. alone for RC dx.
3) Laser therapy was demonstrated to be more effective than placebo for adhesive capulitis but not for supraspinatus tendinitis.
4) There is no evidence of the effect of ultrasound in sh. pain.