Rotator Cuff Repair

Question 1

What type of injury has a slower progression, Chronic Impingement /atraumatic cuff deficiency or acute traumatic injury?

Answer 1

Chronic Impingement/ Atraumatic Cuff Deficiency

Question 2

Stage 1 Characteristics and Pain?

Answer 2

• Edema, Hemorrhage
• Intermittent Pain

Question 3

Stage 1 Typical Ages?

Answer 3

• Younger Individuals
• Athletes

Question 4

Stage 2 Characteristics and Pain?

Answer 4

• Fibrosis and Tendonitis
• Mild to moderate pain
• Pain with Activity

Question 5

Stage 2 Typical Ages?

Answer 5

25 - 40 y/o

Question 6

Which stage will we find pain at night?

Answer 6

Stage 3

Question 7

Stage 3 Characteristics and Pain?

Answer 7

• Pain at rest or with activity
• Night Pain (may be present)
• Weakness of RTC or Scapular Muscles
• Degeneration, Tears, Bone Spurs

Question 8

Stage 3 typical Age range?

Answer 8

Age > 45

Question 9

For Larger RTC tears what type of motion is permitted at the joint, how long?

Answer 9

PROM ONLY; 6-8 weeks

Question 10

What position to begin PROM techniques? Why?

Answer 10

In supine; to stabilize the scapula

Question 11

What muscle group strength should be addressed first?

Answer 11

RTC strength addressed prior to large primary movers (i.e Deltoids and Traps)

Question 12

What substitution is common and should be discouraged during active flexion and abduction?

Answer 12

Shoulder Hiking

Question 13

Type of Strengthening should we initiate with?

Answer 13

Isometrics

Question 14

Time frame in which closed kinetic chain activities are prohibited?

Answer 14

At least 6 weeks

Question 15

When to start dynamic/open chain strengthening? Small vs Large Tears?

Answer 15

8 weeks for Small Tears
12 weeks for Large Tears

Question 16

Caution with which motions are appropriate if the Infraspinatus or Supraspinatus Tendons are Repaired?

Answer 16

• Resisted ER
• Passive IR

(Avoid stretch and avoid contracting the muscles that were repaired)

Question 17

Caution with which motions are appropriate if the Subscapularis Tendons are Repaired?

Answer 17

• Resisted IR
• Passive ER

(Avoid stretch and avoid contracting the muscles that were repaired_

Question 18

When “Reaching Behind Their Head” is mentioned, what motion is most likely occurring at the shoulder?

Answer 18

External Rotation

Question 19

When “Reaching Behind Their Back” is mentioned, what motion is most likely occurring at the shoulder?

Answer 19

Internal Rotation