113. Massive rotator cuff tear rehab. Physio Edge Shoulder success podcast with Jo Gibson

What are the best rehab options for patients with an irreparable rotator cuff tear? Can we predict which patients will do well and how long rehab will take?

Find out in this podcast with Jo Gibson (Clinical Physiotherapy Specialist), discussing rehab options, a patient case study and the latest evidence for massive rotator cuff tear (MRCT) rehab. Discover:

• When patients are unable to have surgery, what rehab options are available to rehab MRCT?
• What is classified as a MRCT?
• What common issues do patients with MRCT face?
• What proprioceptive deficits exist in MRCT patients functionally and on fMRI?
• Is the “Anterior deltoid program” really the best rehab program for MRCT patients?
• What MRCT rehab exercises & programs are supported by the latest research?
• Which MRCT patients are likely to respond to rehab?
• Is scapular dyskinesis important to target in MRCT rehab?
• When patients are unable to lie supine, and are therefore unable to complete the anterior deltoid program, what options are available for rehab?
• How do rotator cuff imaging results help guide treatment?
• Which rotator cuff tendons need to be intact for successful rehab?
• Specific exercise ideas and progressions that can be used in rehab.
• How long is recovery likely to take?
• What key messages are important to convey to patients?
• What is the evidence for injections in MRCT, including prolotherapy, PRP?
• How can rehab programs target subscapularis strength?
• Is humeral head depression an important component in rehab?

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The handout for this podcast consists of articles referenced in the podcast. There is no additional transcript or handout available.

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Articles associated with this episode:

• CLICK HERE to download the articles associated with this podcast

• Agout C, Berhouet J, Spiry C, Bonnevialle N, Joudet T, Favard L, Society FA. Functional outcomes after non-operative treatment of irreparable massive rotator cuff tears: Prospective multicenter study in 68 patients. Orthopaedics & Traumatology: Surgery & Research. 2018 Dec 1;104(8):S189-92.

• Cavalier M, Jullion S, Kany J, Grimberg J, Lefebvre Y, Oudet D, Grosclaude S, Charousset C, Boileau P, Joudet T, Bonnevialle N. Management of massive rotator cuff tears: prospective study in 218 patients. Orthopaedics & Traumatology: Surgery & Research. 2018 Dec 1;104(8):S193-7.

• Cools AM, Van Tongel A, Berckmans K, Spanhove V, Plaetevoet T, Rosseel J, Soen J, Levy O, Maenhout A. Electromyographic analysis of selected shoulder muscles during a series of exercises commonly used in patients with symptomatic degenerative rotator cuff tears. Journal of Shoulder and Elbow Surgery. 2020 Oct 1;29(10):e361-73.

• Levy O, Mullett H, Roberts S, Copeland S. The role of anterior deltoid reeducation in patients with massive irreparable degenerative rotator cuff tears. Journal of shoulder and elbow surgery. 2008 Nov 1;17(6):863-70.