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Rotator Cuff Surgery

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The rotator cuff surgery is the repair of the shabby tendon in the shoulder done with shoulder arthroscopy or open incision. The initial symptom that needs to be managed is the pain followed by swelling (Duncan and Flowers 67). The swelling can occur although it is not common to all people.  However, swelling happen regardless of the amount of pain an individual can ignore or endure.  Thirdly, the rotator cuff adjusts in the range of movement particularly when the arm is raised vertically or parallel to the floor.  The major goal when managing the rotator cuff surgery is to strengthen the muscles in the shoulder evenly while improving the range of motion (Duncan and Flowers 97). The best exercises for the case study based on the 12PT sessions and need to come back for the training program are the range of motion (ROM) and modified strength exercises.

ROM Exercise

Range of motion exercises should be initiated immediately after surgery with the aim of restoring full and pain free movement on the shoulder joint.  The mobility exercise should be conducted at least one time per day or three to four times and the exercise should stay within the range of pain free movement (Duncan and Flowers 119). These exercises include pendulum exercises, pole wand exercise, back and front stretch as well as muscle energy technique.  The exercises should be done appropriately with supervision of the therapist.  For the muscle energy technique, the therapist has to rotate the shoulder without pain after which the patient pushes against the rotation with 20 percent maximum force (Duncan and Flowers 123). After pushing, the patient should relax while the therapist applies stretch by amplifying the ROM.

Modified Strength Exercise

The strengthening exercise should start with static or isometric activities progressing into dynamic exercises with dumbbells or resistance band and finally to the more functional or sport specific exercises utilizing medicine balls.  The major goal of modified strength exercise is to restore the power of the muscles and to prevent future injury.  The exercises appropriate for strengthening the rotator cuff include isometric exercises, scaular squeeze, lateral rotation, internal and external rotation (Duncan and Flowers 121). Besides, isometric exercises focuses at strengthening the muscles so that to stabilize the shoulder or scapula during the early stages of rehabilitation program.   Moreover, static exercises should be performed within 3 to 7 days as long as there is no pain.  However, the dynamic strengthening exercises that can be done using dumbbell weights or resistance band can replace the static activities after seven days.  

Routine Plan

The patient should start with ROM after which the strengthening exercises can be conducted after 3-7 days when there is no pain.  However, the exercises can be alternated when the pain ends to improve the power and mobility of the joint.  

 

Exercise

Aim

Day one

Pendulum exercise -2 to 3 times lasting at least 15 minutes

To increase mobility  and reduce pain

Day Two

Pole exercise-2 to 3 times lasting 15 minutes

To relax and increase the movement of the injured muscles and alleviate pain

Day Three

Muscle energy method –3 to 5 times a.

To improve the rotation of the joint and increase motion while decreasing pain.

Day Four

Isometric exercises –at least once per day lasting 15 minutes or more

To strengthen the shoulder muscle

Day Five

Lateral rotation in prone -2 to3 times

To improve the strength and alleviate pain

Day Six

Internal rotation – 2 to 3 times

To strengthen the muscle

Day Seven

Lateral rotation in standing- 4 or more times

To strengthen the scapula and the shoulder

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