PT News: Under Repair - Communication is a Crucial Component to Rehab After Rotator Cuff Surgery

By WebPT Members Michael J. Mullaney, DPT, and Christine M. Mullaney, DPT

Before orthopedics clearly understood the rotator cuff's role in shoulder function, it was thought that simply "covering the hole" with various techniques was the key to success.1Today, clinicians have a better understanding of rotator cuff function and the importance of recreating the balanced force couples in the shoulder to restore maximal function.

Rotator cuff tears can result from an acute injury or a chronic, degenerative process that possesses intrinsic and extrinsic factors. Most often these intrinsic factors are associated with age degeneration, poor vascularity, overuse and calcific tendinitis. Extrinsic factors are associated with structures such as the acromial arch slope, corococlavicular ligament arch height and acromial spurs.

In sports, chronic tears are more common and usually occur from a combination of poor technique and muscular imbalances during activities that require a follow-through motion, such as repetitive throwing or overhead strokes. Pitchers, swimmers, tennis players and golfers are particularly vulnerable, as are athletes who participate in the discus, shot put and javelin. Acute tears occur when the shoulder is loaded with intense stress or pressure, such as during weightlifting.

The first line of defense is typically a non-surgical approach, which includes physical therapy. However, if function isn't regained through conservative measures, surgical intervention may be required. Although athletes are under the guidance of an orthopedic surgeon after surgery, therapists must understand the dynamics of different rotator cuff repair methods. In addition, communication between the orthopedic surgeon and treating therapist is essential to optimize outcomes.

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