Dear Indra
The most important thing in the rehab of a shoulder is to ensure the correct
balance of the rotator cuff. Subscapularis must be trained to maintain the
position of the humeral head on the glenoid or the surgery will be a waste
of time. Also, remember that the scapula must be stable for the cuff muscles
to work from. In particular the serratus anterior has benn shown to be the
most important. If the articulations are well aligned there will be less
joint stiffness developed.
Try passively positioning the humeral head on the fossa in sitting or supine
in the allowable range of abduction, and ask the patient to hold the
position. Build up to get the patient to actively position the humerus. When
you are allowed to abduct to 90degrees, add maintaining position with
eccentric then concentric motion.
Serratus anterior can be worked in all-fours by lifting the chest away from
the hands. Progressing to unilateral weightbearing. Then press ups using
triceps. Always maintaining the scapula against the chest wall.
Hope this is helpful
Ann McCarthy
>From: Syahmirza Indra Lesmana <[log in to unmask]>
>Reply-To: [log in to unmask]
>To: "[log in to unmask]" <[log in to unmask]>
>Subject: Repair Rotator Cuff Tear
>Date: Tue, 18 Jul 2000 14:50:11 +0700
>
>Dear all
>
>Would you give me program PT for repair rotator cuff tear with open
>operation and atrhoscopy .
>In my experience I always have stiff joint in GHJ on my patient with Repair
>Rotator Cuff tear. So I need information what I must to do.
>Thank You
>
>Indra Lesmana
>Siaga Raya Hospital
>Jakarta Indonesia
>
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