Shoulder surgery

Question 1

Types of RC repair

Answer 1

• Arthroscopy- minimally invasive, +/- subacromial decompression
• Mini-open repair- small incision, avoids deltoid detach, risk of axillary N damage
• Open- more traditional, incision over AC Jt, detach deltoid

Question 2

Phase 1 RC rehab principles

Answer 2

• 0-6/52
• No active movement- pendulums and assisted ROM from 8/7 to 6/52
• Avoid abduction if deltoid detatched
• Avoid H Add, Ex and IR
• Avoid agg movements, postures, lying for 12/52
• Can’t test RC strength until surgeon allows

Question 3

Phase 2 RC rehab principles

Answer 3

• 6/52 – 3/12
• Stop wearing sling
• No overhead activities
• Lift up to 1kg to chest level
• AROM and isom focus

Question 4

Phase 3 RC rehab principles

Answer 4

• 3-6/12
• AROM
• Isom&raquo_space; concentric
• Technique
• Function/RTW activities
• Light 2-5kg lifting
• Occasional light overhead work < 15mins

Question 5

TSR principles

Answer 5

• Severe OA
• Pecs and subscap detached- avoid add and IR movements
• Start early w long term goals
• Progression of rehab target based rather than time

Question 6

Conservative Mx of frozen shoulder

Answer 6

• NSAIDs
• Oral corticosteroids for ST benefits
• Manual mob and stretching
• High grade > low grade
• Heat therapy
• At home care
• If 6+/12 of cons. Mx before surgery considered

Question 7

Humerus #

Answer 7

• Neck:
o Non-op = pendular after 1/52, C + C sling
o Op = pendular after 1/7, broad arm sling
• Shaft:
o Non-op = pendular after 1-2/52, C + C
o Op = pendular 1/7, flex 2/52, no ABd 6/52, broad arm