Once you have been diagnosed with a partial or complete ACL tear, there are both non-surgical and surgical options. If the overall stability of the knee is intact, non-surgical options may be advised, including the use of a brace and physical therapy for a balance training and muscle strengthening program. The avoidance of cutting and pivoting movements is recommended. If these methods don't relieve symptoms, surgery may be necessary. Open and arthroscopic surgery may be performed, followed by rehabilitation program to address strength and mobility.
After your physician has diagnosed you with a rotator cuff tear, there are two treatment options; non-surgical and surgical. The non-surgical options would include rest and limited overhead motions, use of a sling, anti-inflammatory medication, steroid injuection(s), and physical therapy to strengthen the shoulder.
The second option would be surgery. This would occur if previous treatments have failed to relieve symptoms, it is a fairly new and large tear, or if the tendon is torn away from the bone. There are three major types of repairs: open, mini-open, and arthroscopic repairs.
Rehabilitation after rotator cuff surgery can be a slow process. You will probably need to attend therapy sessions for two to three months, and you should expect full recovery to take up to six months. Getting the shoulder moving as soon as possible is important. However, this must be balanced with the need to protect the healing tissues.
Your surgeon will most likely have you wear a sling to support and protect the shoulder for several weeks (generally four to six weeks) after surgery. Ice and electrical stimulation treatments may be used during your first few therapy sessions to help control pain and swelling from the surgery. Your therapist may also use massage and other types of hands-on treatments to ease muscle spasm and pain.
Therapy can progress quickly after arthroscopic procedures. Treatments start out with range-of-motion exercises and gradually work into active stretching and strengthening. You just need to be careful about doing too much, too quickly.
Therapy goes slower after surgeries where the front shoulder muscles have been cut. Exercises begin with passive movements. During passive exercises, your shoulder joint is moved, but your muscles stay relaxed. Your therapist gently moves your joint and gradually stretches your arm. You may be taught how to do passive exercises at home.
Active therapy usually starts 6 weeks after surgery. You use your own muscle power in active range-of-motion exercises. You may begin with light isometric strengthening exercises. These exercises work the muscles without straining the healing tissues. At Northern Michigan Sports Medicine Center, we utilize aquatic therapy to allow you to initiate active motion without stressing your repaired rotator cuff tendon. Formal strengthening exercises will be delayed until 12 weeks.
Exercises focus on improving the strength and control of the rotator cuff muscles and the muscles around the shoulder blade. Your therapist will help you retain these muscles to keep the ball of the humerus firmly in the socket. This helps your shoulder move smoothly during all your activities.
Some of the exercises you'll do are designed to get your shoulder working in ways that are similar to your work tasks and sport activities. Your therapist will help you find ways to do your tasks that don't put too much stress on your shoulder. Before your therapy sessions end, your therapist will teach you a number of ways to avoid future problems.