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Post Surgical Rotator Cuff Physical Therapy

Post Surgical Rotator Cuff Physical Therapy

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Post Surgical Rotator Cuff Physical Therapy

A patient will typically be referred for rotator cuff surgery when 90% or more of the tendon is torn. The most common causes for rotator cuff injuries are aging, overuse of overhead activities and heavy lifting. Surgery should never be taken lightly, so we wanted to take some time to inform you about what to bring before surgery, things that can help you immediately after and then give an idea of what to expect as you go through a post surgical rotator cuff physical therapy treatment plan. These are general guidelines. More specific expectations can be given by your healthcare provider.

Items to bring with you before rotator cuff surgery

  • Sling
  • Ice Pack or Cold Therapy Unit

Using your sling

  • You will usually wear for about 4 weeks. (Removing only to wash up and do exercises)
  • Avoid ANY active reaching or lifting up to 6 weeks
  • Getting Dressed
    – Place involved arm in sleeve first.
    – Put your belt in pants first.
    – Slip on shoes is recommended.
  • Sleeping
    – It may be more comfortable sleeping in a recliner instead of a bed.
    – Support your arm with a towel roll or pillow if lying down.
  • Avoid showering for the first couple of days.  (Once able to shower, lean over to let your healing arm hang away from your body, while you use the other to wash.)

Icing your shoulder (Ice Pack or Cold Therapy Unit)

  • Ice for 20 minutes in your waking hour for the first few days.
  • Decrease to 3-5 times a day as needed for pain.

General Care

  • Change dressing daily as recommended by your physician/nurse.
  • No driving especially if right arm and if taking pain medications.
  • Walk around your home at least 1 time each hour to prevent blood clots.
  • Begin therapeutic exercises as soon as instructed

After being cleared for physical therapy, the normal course of a POST-SURGICAL rotator cuff physical therapy has been described as having five stages:

Stage 1: Immobilization

There is a mandatory period of rest for the arm following a rotator cuff surgery. The tendons have been repaired but need to wait through the biological healing phase in order to be able to accept the strain of moving the arm. This period may last 4-6 weeks and may be intermittent with the therapist being able to do slight motions to the arm to keep the joint from getting stiff.

Stage 2: Passive motion

During and after the immobilization phase, you’ll begin performing passive motion exercises. At first, the therapist will provide the muscle to move the arm, but over time, you’ll be educated in the use of pulleys, stretch straps and table stretches to allow the joint to move while keeping the muscles fully relaxed.

Stage 3: Active-Assisted motion

Once the shoulder has achieved full expected passive motion, and with the permission of the surgeon, your therapist will begin active-assisted motion. This type of exercise uses less than 100% of the surgical shoulder’s power to move the arm. The therapist may instruct you in pendulum exercises that employ gravity and momentum. Self-ranging exercises use the uninvolved arm to move the involved arm, either against the weight of gravity or lying down so that the weight of gravity is minimalized. The surgical arm’s responsibility will slowly increase up to 100% of the weight of the arm. Then, you’ll be ready for active motion.

Stage 4: Active motion

The active motion phase begins when the arm is able to carry its own weight against gravity but is not yet ready to lift, push or pull objects. During this phase, your therapist will demonstrate safe motion patterns of the shoulder and shoulder blade. They will monitor the coordination of movement between the muscles to check for specific weakness that could put strain on the repair. Once you can achieve full expected active range of motion against the weight of gravity, and with your physician’s approval, you’ll be ready to add weight.

Stage 5: Strengthening

The strengthening program may start out slowly. Be patient! The muscles are relearning how to work together so inflammation of the tendons and bursae are still a risk in this phase. Your therapist will recommend exercises that you can do at home in order to improve the arm’s tolerance for strength and to reduce the strain on the arm when you come into therapy. Over time, the therapist will demonstrate ways that you can safely use the arm for pushing up from a chair, pulling a door open, reaching into a cabinet and other activities of daily living.

Post surgical rotator cuff physical therapy care can vary based on the patient’s needs and ability levels. Depending upon the severity of the tear, physical therapy can work with patients to heal the tendon and reduce pain. To find a physical therapist near you click the button below.

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post mastectomy physical therapy

Post-Mastectomy Physical Therapy

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The word cancer is a scary one. Even though we all hope that it never becomes part of our lifetime of trials, more often than not, we know someone that has had, or is currently dealing with cancer. It is a testament to the medical community that so many women are able to wear the pink ribbon as a sign of triumph and pride, but we still mourn with those that wear it as a sign of remembrance and loss. More than once, while talking with women that have begun treatment for breast cancer, the topic of whether or not to have a mastectomy has come up. It’s not a decision taken lightly, often one with multiple concerns about what happens after surgery. Will the cancer be gone for good? Will it hurt? How long will it take to recover? A physical therapy post mastectomy program can help address these issues.

Physical Therapy can’t answer all of those questions, but one thing a physical therapy post mastectomy program can do is aid in the overall recovery process by focusing on regaining strength and increasing the range of motion in your shoulder and arm. Early intervention by a physical therapist can help women regain full function following mastectomy surgery, regardless of whether or not a woman has had reconstruction. Rehabilitation is always tailored to each patient’s specific needs. Not every patient experiences the same recovery, and as such physical therapists are prepared to help patients experiencing a multitude of symptoms – some have been highlighted below.

Size, location and the type of mastectomy are important considerations when choosing a type of treatment. Exercises to maintain shoulder range of motion and arm mobility may be prescribed as early as 24 hours after surgery.  These exercises are important in restoring strength and promoting good circulation. As rehabilitation progresses these exercises may be modified to meet new goals.

After mastectomy surgery, patients may experience tightness around the surgical site. This is caused by scar tissue formation. The result can be very dense tissue under the incision, which is painful and can restrict range of motion.  The restricted range of motion puts a woman at risk for a painful condition known as frozen shoulder. Early treatment by a physical therapist can help reduce the pain and help regain functional range of motion and strength.

Numbness and/or nerve sensitivity at the surgical site can develop post-mastectomy. Manual therapy can help restore sensation and relieve nerve pain. In severe cases, a chronic condition known as post-mastectomy pain syndrome may develop.  This is caused by scar tissue impinging on nerves. Physical therapy can be very effective at releasing scar tissue and reducing this nerve related pain.

Axillary node dissection can lead to a condition known as cording or axillary web syndrome.  Cording presents as a moderate to painful tightening, which appears as “cords” emanating from the armpit and extending down the arm. Cording significantly restricts range of motion and arm function. Manual therapy and therapeutic stretching helps to resolve this condition quickly.

Radiation treatment after mastectomy surgery can exacerbate posture and range of motion problems, causing fibrosis and skin tightness. Manual therapy can remediate these issues and may prevent them from ever becoming a problem.

The Benefits of Exercise and Physical Therapy post mastectomy treatment programs can differ greatly as seen above, but there are a few benefits that all patients can benefit from:

  • Improved shoulder range of motion
  • Improved shoulder strength
  • Improved functional mobility
  • Improved posture
  • Decreased pain at the surgical site
  • Decreased edema on the affected side
  • Improved sensation at the surgical site

Meeting with a physical therapist before surgery can help you feel more at ease and more confident in your overall recovery goals. It’s never too early to ask questions! To find a physical therapy clinic near you click here.

For more information on cancer related physical therapy programs click here:

    
PREHAB Knee Replacement

PREHAB Move to Improve Your Goals: Total Knee Replacement

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PREHAB Home Preparation
Before total knee replacement surgery there are a few simple things you can do in your home to make it safer and more comfortable during recovery.

  • Consider keeping a cordless phone near you or carry your cell phone in your pocket.
  • Move furniture to keep a clear wide path to your kitchen, bathroom and bedroom.
  • Remove throw rugs that may cause you to slip or trip. Tape down any loose edges of large area rugs that cannot be removed. Make sure extension cords are out of traffic areas or tape them down if needed.
  • Wear rubber sole shoes to prevent slipping.
  • Keep commonly used items in your home at waist level within easy reach. This will prevent you from bending over to reach items. Use a reacher to grab objects and avoid excessive bending at the knee.
  • Make sure there is adequate lighting in the house. Add night lights in hallways, bedrooms, and bathrooms.
  • It may be helpful to have temporary living space on the same floor if your bedroom/bathroom is located on the second floor of your home. Walking up/down stairs will be more difficult immediately following surgery and could increase your risk for falls.
  • Arrange for someone to collect your mail and take care of pets or loved ones if necessary.
  • Prepare frozen meals in advance to assist you with cooking.
  • Stock up on groceries, toiletries, and any needed medications you might need.
  • A shower chair or a tub bench will make bathing much easier. Do not take soak baths until your physician allows you to do so.
  • An elevated toilet seat will be helpful with toilet transfers and with following post surgical precautions or guidelines.
  • Assistive devices for dressing such as a reacher, extended shoe horn and / or sock aid may be necessary during your post operative recovery.

While it’s important to prepare your home before surgery, PREHAB should also include physical therapy. Physical therapists will work with patients to create an exercise program before surgery that can help improve performance and decrease recovery times after a total knee replacement. Talk to a PT near you and learn about the benefits of PREHAB before total joint replacements.

postoperative physical therapy

Postoperative Physical Therapy

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Postoperative physical therapy after a Total Hip Replacement is essential to your recovery. Your physical therapist will follow your physician’s protocol and will focus on range of motion exercises, progressive strengthening exercises, gait training, balance training, and activity specific training to meet your specific needs. Modalities such as ice and e-stim may be used to help reduce discomfort and swelling. It is very important to complete your home exercise program as directed by your physical therapist and physician.

RANGE OF MOTION EXERCISES
Swelling and pain can make you move your knee less. Your physical therapist can teach you safe and effective exercises to restore the range of motion to your knee so that you can perform your daily activities.

STRENGTHENING EXERCISES
Weakness of the muscles of the thigh and lower leg is typical after surgery. Your physical therapist can determine the best strengthening exercises for you with the goal of no longer needing a cane or walker to walk.

post op

BALANCE TRAINING
Specialized training exercises can help your muscles “learn” to adapt to changes in your world such as uneven or rocky ground. When you are able to put your full weight on your knee without pain, your physical therapist may add agility exercises so that you can safely and quickly change directions or make quick stops or starts. They may use a balance board that will challenge your balance and knee control. These exercises will be safe and fun.

GAIT TRAINING
Your physical therapist will work with you in retraining your gait following your surgery using appropriate assistive devices such as a walker or cane. They will make sure that you will be able to safely and confidently go up and down stairs, negotiate curbs, and inclines, etc.

ACTIVITY SPECIFIC TRAINING
Depending on the requirements or your job or the type of recreational activities you enjoy, your physical therapist will tailor your program so that you can meet your specific demands.

This article about postoperative physical therapy was written by STAR Physical Therapy, an outpatient physical therapy group with over sixty locations in Tennessee. Established in 1997 with one clinic and one mission – to serve. Today, they have grown to offer that direct service in more than 60 clinics, and while they’ve grown, one thing that has not changed is their commitment to you, their communities, and their employees. For more information click here.