Regeneten for Shoulder Rotator Cuff Partial Thickness Tears (Without Full Repair)

Regeneten for Shoulder Rotator Cuff Partial Thickness Tears (Without Full Repair)

Introduction

These rehabilitation guidelines are designed for patients who have undergone a Regeneten Bioinductive Implant for partial-thickness rotator cuff tears without a full repair. The physiotherapy plan should be individualized, with all exercises performed without pain. Restrictions and details should align with the post-operative instructions. If instructions are unavailable, patients should contact the consultant’s secretary.

Rehabilitation emphasizes:

• Soft-tissue healing protection.
• Restoration of movement and strength.
• Addressing the shoulder girdle, kinetic chain, and core stability.

Rehabilitation Phases

Phase 1: 1-7 Days

Goals:

• Protect Surgical Site:
  • Wear the sling at all times, except for dressing, washing, or exercises.
  • Teach proper sling use, dressing, and personal hygiene techniques.
• Wound Healing:
  • Ensure the surgical site remains clean and dry.
• Pain & Inflammation Management:
  • Use analgesics, NSAIDs, ice, and proper posture.
• Prevent Stiffness and Regain Motion:
  • Gradually increase Passive Range of Motion (PROM) as tolerated:
    • Pendulum exercises.
    • ER/IR and Forward Flexion (FF) (check post-operative instructions for restrictions).
• Teach Scapular Control:
  • Focus on scapular retraction and depression.
• Upper Limb Mobility:
  • Perform hand, wrist, elbow, and neck ROM exercises.
• Sleeping Position:
  • Use the sling while sleeping; place a pillow beneath the elbow to prevent shoulder extension.

Precautions:

• Wear the sling for 1-3 days (as advised in post-op instructions).
• Avoid:
  • Lifting objects over 5 lbs.
  • Excessive shoulder extension or stretching.
  • Supporting body weight with the operated arm.
• No driving for 1 week.

Milestones:

• Pain and inflammation are well-managed.
• Return to pre-operative sleep patterns.
• Good scapular setting established.

Phase 2: 1-6 Weeks

Goals:

• Continue managing pain, inflammation, and muscle inhibition.
• Gradually restore full pre-op PROM without forcing painful motions.
• Progress from Active-Assisted ROM (AAROM) to Active ROM (AROM):
  • Maintain a pain-free range with good scapular-humeral rhythm (SHR).
• Strengthening:
  • Begin sub-maximal isometric shoulder girdle contractions, progressing to light isotonic strengthening.
  • Include lower limb and core strengthening.
• Promote postural awareness and prevent muscular inhibition.
• Gradually return to light, non-repetitive functional activities, weaning out of the sling as tolerated.
• Start scar massage once stitches are removed.

Precautions:

• Avoid:
  • Excessive loading or stretching of the shoulder.
  • Prolonged or repetitive upper limb activities.
  • Supporting body weight on the operated arm.

Milestones at 6 Weeks:

• Full pain-free ROM with good SHR.
• No pain or tenderness upon examination.

Phase 3: 6 Weeks and Beyond

Goals:

• Strength, Power, and Endurance:
  • Introduce scapular stabilisation exercises.
  • Gradually progress to full shoulder and upper limb strengthening, ensuring pain-free ROM with good SHR.
• Neuromuscular Control:
  • Incorporate proprioceptive exercises and progress to dynamic and rhythmic stabilisation exercises.
• Progress functional activities, including:
  • Sport-specific tasks for athletes.
  • Overhead activities like throwing.
• Return to Sports:
  • Begin at 12 weeks and beyond, ensuring adequate strength for sport-specific demands.

Contact Information

• Consultant Secretary: 07810356433
• Sulis Hospital Physiotherapy: 01761 422388
• Circle Health Group Bath Clinic Physiotherapy: 01225 838767
• St. Joseph Physiotherapy: 01633 820321

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