What Is Rotator Cuff Syndrome?

The rehabilitation of rotator cuff injury refers to the systematic rehabilitation training after non-surgical comprehensive treatment and surgical treatment.

Rotator cuff injury rehabilitation

The rehabilitation of rotator cuff injury refers to the systematic rehabilitation training after non-surgical comprehensive treatment and surgical treatment.

After rotator cuff injury, no matter surgical or non-surgical treatment, systematic rehabilitation training should be carried out. All rehabilitation training should be completed under the guidance of a rehabilitation therapist.

Postoperative rehabilitation training: The patient wore a shoulder sling after surgery, and the removal time was subject to the opinion of the clinician.

The treatment plan is divided into three stages

The first stage (0 ~ 6 weeks after surgery):

Normal braking of the joint for 4 weeks will cause a considerable degree of contracture, while braking of the injured joint for 2 weeks will result in fusion of connective tissue fibers and loss of joint motor function. If the swelling is not treated in time and lasts more than 1-2 weeks, it will inevitably Aggravate local adhesions and limit functional activities. Therefore, we require patients to apply ice on the shoulder to reduce swelling and increase the pain threshold. At the same time, actively move the hands, wrists, and elbows, raise the affected limb, and passively move the shoulders to reduce adhesions.

0-6 weeks

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Within 0 ~ 3 weeks after operation, the shoulder strap should be used to protect the body in a comfortable position, and should not bear weight and exert excessive force. Otherwise, it will affect the function recovery of the tissue healing agent. Shoulder strap protection time depends on pain and muscle strength.

1. Circles and pendulums: Healthy hands assist the affected upper limb to swing forward and backward, left and right, and circle clockwise and counterclockwise;

Pendulum movement, also known as Coldman's movement, is a self-relaxing method of the shoulder joint. Bend forward (bend over) until your upper body is parallel to the ground, and swing your arms under the protection of a triangle scarf and healthy hands. The first is the front-back direction, and the left-right lateral direction is increased after the adjustment is basically painless. Finally, the ring (circling) movement is increased to gradually increase the range of motion, but not more than 90 °.

2. Exercises of adjacent joints of hands, wrists, forearms and elbows (active); all 3 / d, 5 ~ 10 / times;

Hands: grasp, stretch

Wrist: Palm flexion, dorsiflexion, ulnar deviation, radial deviation, circular rotation

Forearm: pronation, supination

Elbow: Flexion, extension

3. Cold compress pain area, 3 ~ 6 times / d, each time 20 --- 30min;

4. Passive exercise, passive movement of the shoulder joint forward flexion and lateral external rotation on the first day after surgery, passive movement of shoulder abduction, internal rotation and abduction external rotation on the first 3 to 4 days after surgery;

Shoulder joint flexion: The patient should lie flat on the bed, straighten the upper arm of the affected side, and hold the elbow of the affected limb on the healthy side. When the affected limb is not in use, the affected side is forced to lift the affected limb as far as possible to the maximum angle, and it is maintained at this angle for 1 minute.

Shoulder joint lateral rotation: The patient lies in bed. The affected elbow joint is flexed 90 ° and is placed close to the body. The healthy side uses a wooden stick against the affected side's palm. While maintaining the elbow joint on the affected side close to the body side, try to push the affected side's hand outwards, and also maintain it for 1 minute when it reaches the maximum.

Shoulder abduction: The patient should lie flat on the bed, hold a wooden stick in front of the body, push the healthy side towards the affected side, so that the upper limb of the affected side is attached to the bed surface, and the shoulder joint is extended, and it is maintained for 1 minute when it reaches the maximum.

Shoulder joint abduction and external rotation: The patient should lie on the bed with the elbow joint flexed 90 ° on the affected side. The elbow does not need to be close to the body. The shoulder joint on the affected side should be abducted as much as possible, within 90 °, 90 ° is the best. Both the hands and the hands are holding one end of the stick, and the healthy hand pushes out the affected hand as far as possible. Pay attention that the upper arm should not leave the bed surface, and it also maintains for 1 minute when it reaches the maximum.

Shoulder joint rotation: The patient is in a standing position with the affected limb behind his back and the healthy side with his hands behind his head. Hold both ends of a towel with both hands. When the affected limb is not used, the healthy hand pulls up the affected hand as much as possible through the towel held, and maintains it for 2 minutes when it reaches the maximum.

5. Perform deltoid isometric contraction training after suture removal 2 weeks after surgery: before, during, and after exercise, 3 times / d, 5-10 times / time.

Isometric contraction: When the muscle contracts, its length does not change but only the tension increases. This contraction is called isometric contraction, also known as static contraction.

Deltoid isometric contraction training: the patient lies in bed. The affected side is holding a fist, and the elbow joint is flexed 90 ° and close to the body. On the premise of keeping the body, shoulder joints, and upper limbs in position, resistance training is performed on the front, the outside, and the back.

The second stage (7 ~ 12 weeks):

1. Actively assist joint training after removing the sling: shoulder ladder, pulley, etc .;

2.Stand position using sticks for forward flexion, abduction, external rotation and other exercises

7-12 weeks

, 3 times / d, 5 ~ 10 times / time;

Standing position, holding the sticks in both hands, the healthy hand drives the patient to practice.

3. Continue to practice isometric contraction of shoulder muscles;

This stage of training can be performed with standing position, but the principle of keeping the trunk, affected shoulder and upper limbs still

4. Posture correction; maintaining good habits and posture in daily life is just as important as rehabilitation training. It can not only help rehabilitation training, but also avoid unnecessary complications.

sleep

If you sleep well and wake up without pain, don't change your habits. If you have shoulder discomfort while you are sleeping, then avoid using your affected limb to rest your head on your head, as that will not be good for blood circulation. At the same time, multiple pillows can be used to keep limbs slightly abducted

Daily activities

In the early days, to avoid holding objects with both upper limbs above the horizontal level of the shoulder, it is necessary to keep the elbow bent and close to the body when long-term repeated operations or heavy objects are required. Try to use foot pads or small benches when lifting objects above your head

Posture training:

a.Retract the scapula while retracting the mandible

Sitting or standing, with the mandible inwardly retracted, while extending the scapula backwards and backwards, avoid forward flexion or neck extension, and keep your eyes straight forward.

b. Active forward flexion of the shoulder joint and keeping the upper trapezius muscles relaxed:

Lift your upper limbs forward and keep your shoulders relaxed and avoid shrugging. Train in front of the mirror, or place your hands on your shoulders.

5. Daily life action training (comb hair, bathing, etc.).

Before training, you can do a hot compress and start training after the muscles relax. Note: The affected side cannot bear weight. Do not repeat the action quickly and repeatedly during the exercise. Try to use the affected side for daily activities.

The third stage (after 12 weeks):

At this stage, the rotator cuff rebuilt or repaired has basically healed. In addition to continuing to strengthen the previous movements, terminal stretching and strength exercises can be performed

After 12 weeks (3 photos)

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Use the door, table, etc. to pull the shoulder joint in all directions, 3 times / d, 5 ~ 10 times / time, each time it needs 10 ~ 20s;

a. Door frame chest muscle pull training

Upper arm abduction, elbow forearm with door frame. The trunk slowly turns to the opposite side until you feel the chest muscles pulling.

b. Adduction after shoulder training

The shoulder joint is retracted 90 degrees forward and the contralateral hand is stretched at the elbow joint to help pull.

c. Shoulder flexion training

The standing position faces the wall, sliding your hands up and slowly approaching the wall to increase traction.

Use dumbbells, elastic bands, etc. to perform strength exercises in all directions, 2-3 times / d, 15 times / time, it will take 5-10 seconds to reach the end point. The following are a few key movements to maintain the balance of shoulder muscle strength.

a. Shoulder joint body resistance and internal rotation training

Hold one end of an elastic rubber band, the other end of the rubber band is fixed somewhere, and pull the rubber band to the outside forcefully. Hold for a certain time to the maximum angle or complete the action once. The amount of resistance can be adjusted by the elasticity of the rubber band.

b. Shoulder joint resistance extension training

Hold one end of an elastic rubber band, the other end of the rubber band is fixed somewhere, and pull the rubber band backwards. Hold for a certain time to the maximum angle or complete the action once. The amount of resistance can be adjusted by the elasticity of the rubber band.

c. Shoulder flexion training

Hold one end of an elastic rubber band, step the other end of the rubber band under your foot, and pull the rubber band upwards. The amount of resistance can be adjusted by the elasticity of the rubber band. Be careful not to shrug and keep your thumbs up.

Multi-sport training: Allow patients to swim, jog, and ball sports with a small amount of exercise to restore the coordination of the upper limbs and the accuracy of the exercise.

All activities must be performed within the range of pain tolerance during training. At the same time, it can assist physical therapy and drugs to control inflammation and reduce pain