Rotator Cuff Surgery Assignment 2022

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Rotator cuff Surgery
student
9/26/2019

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Table of Contents
Introduction.................................................................................................................................................2
Strengthening and stretching program.....................................................................................................2
Conclusion...................................................................................................................................................5
References...................................................................................................................................................6

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Introduction
Rotator cuff problems are mostly treated at home, however, if the problem is severe, or
remains for a longer period, the patient might require surgery. The rotator cuff is the group of
tendons and different muscles of the shoulder which functions to lift and rotate the arm. When
the rotator cuff tendons start tearing or punched by different bones around them. Wear and tear
for a long term can affect the shoulder too and the pain might be severe (Osborne, Gowda,
Wiater & Wiater, 2016). In this particular health issue, a 12-week strengthening and stretching
program for the patient after surgery will be discussed.
The athlete had a rotator cuff injury and completed physical therapy. He has been
recommended to go through a 12-week strengthening and stretching program.
Strengthening and stretching program
To get back the athlete to activity, the strengthening and stretching programs will be
provided which comprised of 4 phases. The initial 12 weeks come under the three initial phases
of the program. The 12-week strengthening and stretching program will include different
exercises essential for increasing muscle strength (Piitulainen et al., 2015).
For 0 to 4th week
For 0 to 4th week of the program, some of the activities will be applied are slings, use of
the affected arm, and showering. In the sling activity, the patient will use the slings most of the
time and it will be detached for 4 to 5 times to perform pendulum movement (Camargo et al.,
2015). The patient will be using hi affected arm in the front side of his body. Although there are
some restrictions he must follow including not lifting any object, not performing excessive

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shoulder extension, not doing excessive stretching or unexpected movement, and not supporting
the bodyweight by his hands. The patient will be allowed to take a shower or bath and wash his
incision area (McCormick, Wilcox III & Alqueza, 2015).
Some of the exercises he will be performing in the first week are pendulum exercise,
supine external rotation (SER), the supine passive arm elevation (SPAE), scapular retraction,
shoulder shrug, ball squeeze exercise, and behind the back internal rotation after the 3rd week of
surgery. These exercises will be performed by the patient for 15 to 20 minutes and 4 to 5 times
per day in a week. The main goals of the of these exercises are to safeguard the rotator cuff
repair, making sure the wound healing, preventing the stiffness of shoulder, and regain the range
of motion. These exercises will help in stretching and active motion (Lewis, 2016).
From 4th to 8th week
From 6th to 12th week of the program will continue the activities performed by the patient
in last 6 weeks that are a sling, using the operated arm, and bathing and showering (McCormick,
Wilcox III & Alqueza, 2015). The sling will be used only of the physician allowed to perform it
after 6th week. The patient will continue to evade lifting the arm away from his body, although he
will be allowed to lift his arm to forward in front of his body. For bathing and showering, he will
be continuing to follow instructions of the last 6 weeks (Nikolaidou, Migkou & Karampalis,
2017).
The exercises in this second phase will focus on the stretching, active motion and
strengthening. For stretching the patient will be performing pendulum exercise, SER, standing
external rotation, wall slide stretch, overhead pullies, SPAE, internal rotation behind the back,
external rotation at 90-degree abduction (Nikolaidou, Migkou & Karampalis, 2017). For active

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type of motion, side-lying external rotation and the prone horizontal arm elevations T and prone
row will be performed. Other different exercises that can be beneficial for the athlete are prone
caption Y, prone extension actively supported arm elevation, and progressing to the standing
frontward flexion with the scapulohumeral rhythm. For strengthening muscles he will be
performing side-lying external rotation, the prone horizontal arm raises T, prone row, prone
scaption Y, prone extension, proprioception drills, scapulohumeral rhythm exercise, and standing
forward flexion. These exercises will be performed by the patient one to three times per day in a
week. The main goal of these exercises is to protect the rotator cuff repair, progress the range of
motion of patient's shoulder, being the moderate strengthening, and regain the range of motion
(Camargo et al., 2015).
8th to 12th week
In this third phase of the program, the patient will be performing sports activities that will
include throwing, ski, weight training, swimming, and running. All the activities will be
performed under the guidance of the physician. To return to the normal activities the athlete must
also perform some exercises in the last phase of the program such as wall side stretch, internal
rotation behind the back, the supine cross-chest stretch, prone extension position, prone scaption
Y, prone row, and standing forward flexion (Kang et al., 2016). The patient will be performing
these exercises a single time for three days in a week. The main goal of activities and exercise of
this phase is to carry on to protect the repair of injury by escaping forceful use patient's arm or
lifting the high weight, restoring complete shoulder motion, restore complete strength of the
shoulder, and slowly return to the normal activities (Sgroi & Cilenti, 2018).

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Conclusion
Rotator cuff surgery commonly performed to treat severe rotator cuff problems. The
athlete had the surgery, will be performing stretching and strengthening exercises. The 12-week
programs will help him to perform normal activities again. In the first phase the patient will be
performing exercise like supine external rotation, scapular retraction, shoulder shrugs etc. in the
second phase he will be doing overhead pullies, wall slide stretch, prone extension etc. the last
phase of this programs will include standing forward flexion, weight lifting, swimming, etc. all
these exercises will be implemented under the guidance of physician. After the successful
implementation of the programs, the patient will be retiring back his normal activities like
running.

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References
Camargo, P. R., Alburquerque-Sendín, F., Avila, M. A., Haik, M. N., Vieira, A., & Salvini, T. F.
(2015). Effects of stretching and strengthening exercises, with and without manual
therapy, on scapular kinematics, function, and pain in individuals with shoulder
impingement: a randomized controlled trial. journal of orthopaedic & sports physical
therapy, 45(12), 984-997.
Kang, J. I., Moon, Y. J., Choi, H., Jeong, D. K., Kwon, H. M., & Park, J. S. (2016). The effect of
exercise types for rotator cuff repair patients on activities of shoulder muscles and upper
limb disability. Journal of physical therapy science, 28(10), 2772-2777.
Lewis, J. (2016). Rotator cuff related shoulder pain: assessment, management and
uncertainties. Manual therapy, 23, 57-68.
McCormick, F., Wilcox III, R. B., & Alqueza, A. (2015). Postoperative rotator cuff repair
rehabilitation and complication management. Operative Techniques in
Orthopaedics, 25(1), 76-82.
Nikolaidou, O., Migkou, S., & Karampalis, C. (2017). Suppl-1, M9: rehabilitation after rotator
cuff repair. The open orthopaedics journal, 11, 154.
Osborne, J. D., Gowda, A. L., Wiater, B., & Wiater, J. M. (2016). Rotator cuff rehabilitation:
current theories and practice. The Physician and sportsmedicine, 44(1), 85-92.
Piitulainen, K., Häkkinen, A., Salo, P., Kautiainen, H., & Ylinen, J. (2015). Does adding a 12-
month exercise programme to usual care after a rotator cuff repair effect disability and

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quality of life at 12 months? A randomized controlled trial. Clinical rehabilitation, 29(5),
447-456.
Sgroi, T. A., & Cilenti, M. (2018). Rotator cuff repair: post-operative rehabilitation
concepts. Current reviews in musculoskeletal medicine, 11(1), 86-91.