Rotator cuff (rtc) repair with biceps tenodesis rehab & Physical therapy protocol

What is Rotator cuff (rtc) repair with biceps tenodesis?

Rotator cuff repair with biceps tenodesis is a common shoulder surgery. It fixes rotator cuff tears and addresses the long head of the biceps tendon, usually arthroscopically for quicker recovery and minimized risks. Simultaneous biceps tenodesis with rotator cuff repair offers therapeutic benefits. Rehabilitation phases include immobilization, passive and active range of motion exercises, strengthening, and sport-specific training to restore shoulder function and strength.

Rotator cuff (rtc) repair with biceps tenodesis rehab Protocol

Following rotator cuff repair with biceps tenodesis surgery, a structured rehabilitation program is crucial for optimal recovery.

Phase I: Immediate Post-Operative (Weeks 1-4)

• Goals: Reduce pain, inflammation, and protect the repair while maintaining basic motion.
• Activities: Sling wear, ice therapy, gentle hand and elbow exercises, passive range-of-motion exercises for the shoulder.

Phase II: Early Range of Motion (Weeks 4-6)

• Goals: Improve passive and active-assisted range of motion.
• Activities: Continue ice therapy as needed, progress to gentle active-assisted range-of-motion exercises for the shoulder.

Phase III: Strengthening (Weeks 6-12)

• Goals: Restore strength and stability to the shoulder and biceps.
• Activities: Introduce light isometric exercises, gradually progress to light strengthening exercises with bands or weights, continue improving range of motion.

Phase IV: Advanced Strengthening and Return to Activity (Weeks 12-16+)

• Goals: Enhance strength, power, and coordination for functional activities and potential return to sports.
• Activities: Gradually increase weight and complexity of strengthening exercises, incorporate proprioceptive exercises, progress towards sport-specific drills under guidance.

Rotator cuff (rtc) repair with biceps tenodesis Physical therapy protocol

Phase 1 (Surgery to 4 weeks):

• Goals: Reduce pain, maintain repair integrity.
• Precautions: Sling immobilization, limited ROM, no resistive biceps exercises.
• Exercises: Passive ROM, wrist/hand exercises, scapular retractions.

Phase 2 (5-10 weeks):

• Goals: Protection of repair, gradual ROM restoration.
• Precautions: Sling immobilization, no active ROM, no resistive biceps exercises.
• Exercises: Active assist ROM, scapular/GH joint mobilizations, light lower extremity exercises.

Phase 3 (11-14 weeks post-op):

• Goals: Restore shoulder strength, normalize scapulothoracic kinematics.
• Precautions: No lifting >5 lbs, continue ice post-therapy.
• Exercises: Strengthening exercises, sport-specific drills, cardiovascular exercises.

Phase 4 (16+ weeks post-op):

• Goals: Achieve full AROM, begin aggressive stretching if needed.
• Exercises: Body Blade exercises, step-ups, UBE with increased resistance, sport-specific training.

Return to Sport-Specific Training (16+ weeks post-op):

• Activities: Increase reps and resistance, isokinetic testing, functional testing, sport-specific exercises.