Rehabilitation protocol following rotator cuff reintegration

Objectives:

•Preventing shoulder stiffening

•Optimizing tendon reinsertion healing.

 

Step 1:
Day 1 – Day 30: phase of rotator cuff fragility

•Orthosis 24/24

•De-contracting massage of the periarticular muscles.

•Passive glenohumeral  mobilization in the plane of the scapula in dorsal decubitus position.

•Passive oscillatory motion.

•Lowering the humeral head.

•No abduction work

•Self-mobilization at home 3 times/day

•Step 2:
Day 30 – Day 45: phase of rotator cuff relative fragility 

Objectives: to stimulate tendon healing and promote proper orientation of collagen in the bone-tendon interface.

•Splint withdrawal (scarf worn at night)

•Very prudent active work involving the abductors and eccentric.

•Active mobilization without resistance, by blocking the scapula.

•Step 3:
After day 45: rotator cuff consolidation

•Absence of constraint

•Active work in progress, but without lifting weights.

•Proprioceptive work in closed chain.

•Dynamic muscle strength recovery.

 

At this stage, the recovery of active and passive mobility must be completed.

A self-rehabilitation program must be initiated.

Daily activities:

•  Driving: 6 weeks

•Swimming: breaststroke six weeks, crawl three months

•Professional activity: office work 2 months, manual labour 3 months.

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