Outpatient Physical Therapy management of a Patient with Postoperative Massive Rotator Cuff Repair, Subacromial Decompression, Distal Acromial Excision and Biciptal Tenodesis
Date of Award
Rotator cuff repair, supraspinatus, infraspinatus, and subscapularis, sub acromial decompression, impingement
Background and Purpose. This case report describes the outpatient physical therapy treatment of a 49-year-old male patient with a left, post-operative, massive, rotator cuff repair involving the supraspinatus, infraspinatus, and subscapularis, subacromial decompression, distal acromial excision and bicipital tenodesis of the long head of the biceps. The purpose of this article is to showcase the importance of physical therapy in post-operative treatment of this patient and other patients with similar diagnosis. The criteria for patient selection included a post-surgical diagnosis with high potential for progression.
Description. The treatment of this patient involved manual therapy including soft tissue mobilization, dry cupping, therapeutic exercises, functional activities, range of motion, stretching, strengthening and postural re-education.
Outcomes. Following physical therapy intervention, the patient improved range of motion to almost full range, good to normal strength, and pain only with weighted overhead activities. The patient reported the ability to perform activities of daily living and home activities without pain or difficulty, however due to his occupation and continued improper scapular mechanics therapy was still needed for decreasing pain due to impingement. The patient discharged himself from therapy after completing 9 weeks of therapy for unknown reasons despite continued deficits.
Discussion. Without physical therapy, this patient would have continued to have deficits following surgery. Range of motion should have been formally measured with goniometry regularly to view improvements throughout the episode of care and patient education and understanding of the home exercise program should have been evaluated and stated in the documentation. A protocol for progression of plan of care should have also been incorporated into the plan of care despite the clinical instructor's experience.
Siebert, Megan, "Outpatient Physical Therapy management of a Patient with Postoperative Massive Rotator Cuff Repair, Subacromial Decompression, Distal Acromial Excision and Biciptal Tenodesis" (2021). Physical Therapy Scholarly Projects. 747.