Richmond & Tri-City Area Glen Allen and St. Francis Medical Center in Midlothian

  • Directions
  • Patient Guide
  • Patient Portal
  • Home
  • About G2
    • About Dr. Goradia
    • About Dr. Chu
    • Blog
  • Conditions
    • Knee
      • ACL Tears – Anatomy, Diagnosis and Treatment
      • Preserve ACL Repair Surgery
      • ACL Reconstruction
      • Knee Replacement
      • Outpatient Knee Replacement
      • Cartilage Problems
      • Meniscus Tear
      • Knee Arthritis
      • Patellofemoral Pain
    • Shoulder
      • Rotator Cuff Tears Richmond Virginia
      • Shoulder Labral Tears in Richmond VA
      • Shoulder Arthritis
      • Shoulder Bursitis
      • Shoulder Injury & Repair Videos
      • Shoulder Replacement
      • Outpatient Shoulder Surgery
    • Hip
      • Common Causes of Hip Pain
      • Total Hip Replacement
      • Hip Related Sports Injuries
      • Arthroscopic Hip Surgery
    • Foot & Ankle
      • Foot Pain
      • Ankle Arthritis
      • Achilles Tendinitis
      • Ankle Sprains
      • Plantar Fasciitis
      • Foot & Ankle Fractures
  • Success Stories
    • Testimonials
  • Contact
    • Locations
    • Make an Appointment
    • Insurance
Menu
  • Home
  • About G2
    • About Dr. Goradia
    • About Dr. Chu
    • Blog
  • Conditions
    • Knee
      • ACL Tears – Anatomy, Diagnosis and Treatment
      • Preserve ACL Repair Surgery
      • ACL Reconstruction
      • Knee Replacement
      • Outpatient Knee Replacement
      • Cartilage Problems
      • Meniscus Tear
      • Knee Arthritis
      • Patellofemoral Pain
    • Shoulder
      • Rotator Cuff Tears Richmond Virginia
      • Shoulder Labral Tears in Richmond VA
      • Shoulder Arthritis
      • Shoulder Bursitis
      • Shoulder Injury & Repair Videos
      • Shoulder Replacement
      • Outpatient Shoulder Surgery
    • Hip
      • Common Causes of Hip Pain
      • Total Hip Replacement
      • Hip Related Sports Injuries
      • Arthroscopic Hip Surgery
    • Foot & Ankle
      • Foot Pain
      • Ankle Arthritis
      • Achilles Tendinitis
      • Ankle Sprains
      • Plantar Fasciitis
      • Foot & Ankle Fractures
  • Success Stories
    • Testimonials
  • Contact
    • Locations
    • Make an Appointment
    • Insurance
  • Home
  • About G2
    • About Dr. Goradia
    • About Dr. Chu
    • Blog
  • Conditions

    Knee

    • ACL Tears – Anatomy, Diagnosis and Treatment
    • Preserve ACL Repair Surgery
    • ACL Reconstruction
    • Knee Replacement
    • Outpatient Knee Replacement
    • Cartilage Problems
    • Meniscus Tear
    • Knee Arthritis
    • Patellofemoral Pain

    Shoulder

    • Rotator Cuff Tears
    • Shoulder Labral Tears
    • Shoulder Arthritis
    • Shoulder Bursitis
    • Shoulder Injury & Repair Videos
    • Shoulder Replacement
    • Outpatient Shoulder Surgery

    Hip

    • Common Causes of Hip Pain
    • Total Hip Replacement
    • Hip Related Sports Injuries
    • Arthroscopic Hip Surgery

    Ankle & Foot

    • Foot & Ankle Fractures
    • Plantar Fasciitis
    • Ankle Sprains
    • Achilles Tendinitis
    • Ankle Arthritis
    • Foot Pain
  • Success Stories
    • Testimonials
  • Contact
    • Locations
    • Make an Appointment
    • Insurance

804-678-9000

Book Appointment Now

Rehabilitation for Large & Massive Rotator Cuff Repairs

Do you have a Large or Massive Rotator Cuff Tear?

Dr. Goradia repairs most large and massive rotator cuff tears with a completely arthroscopic technique. The arthroscope (a small fiberoptic camera) actually allows Dr. Goradia to see more inside of a shoulder than if performing the operation with a large incision. These large tears require the surgeon to have excellent technical skills and experience. No two tears are alike so the surgeon has to indivdualize the treatment for each patient depending on their exact pattern of tearing.

As important as the surgery is the rehabilitation and aftercare. The physical therapist and surgeon must communicate on the patients’ progress and set backs. A cookbook approach to rehab does not work for these repairs. The following is a very general guideline. Dr. Goradia will however send specific instructions to the therapist based on each pateints’ rotator cuff.

In many cases the massive tears have been present for a long time and may have severe retraction, scaring and atrophy. The outcomes of these repairs inferior to repairs of smaller tears. The ultimate goal is to reduce pain and improve function but there shoulde will never be completely normal. No “bridges are burned” with the arthroscopic surgery so that if it fails the patient is still has other options.

Phase I: Early Post-operative Phase for Large & Massive tears

Immobilization

  • External rotation or abduction immobilizer for 6 weeks
  • May not remove at home

Rotator Cuff Rehabilitation Exercises

  • Begin scapular shrugs
  • Begin hand/wrist/elbow motion and grip strengthening to reduce stiffness/swelling and to encourage circulation.
  • If Prescribed by Dr. Goradia: Limited Supine PROM for flexion and external rotation within painfree zone
  • Ice or heat for comfort
  • If Prescribed: begin submaximal isometrics at 4 weeks
  • Use e-stim to reduce pain and swelling particularly around scapula
  • Neck/trapezius, peri-scapular massage

Clinical Follow-Up

Patient will:

  • Return to see Dr. Goradia 1 week, 3 weeks and 6 weeks
  • Follow up with physical therapist as needed during this phase to check progress (usually 2-3 x/week)

Phase II: Large & Massive Tears 6 weeks – 3 months

Clinical Goals

  • Passive ROM at 12 weeks equal to 75% of noninvolved side for:
    • Flexion
    • External rotation
    • Internal rotation
  • Begin strengthening

Testing

  • Bilateral ROM

Rotator Cuff Exercises

  • PROM exercises
    • Supine FF, ER, IR
  • Submaximal isometrics
  • Shoulder shrugs, protraction, retraction
  • Light therabands at 8-10 weeks

Emphasis must be made on scapular stabilization and control.

Clinical Follow-Up

Patient will follow-up 3x/week with therapist
At 8 weeks begin home AAROM with wand for FF, ER, IR and submaximal isometrics

Phase III: Large & Massive Tears 3 to 6 months

Clinical Goals

  • 80-90% ROM
  • Improve strength and function

Testing

  • Bilateral ROM
  • Strength evaluation

Rotator Cuff Rehabilitation Exercises

  • Begin a more aggressive shoulder stretching program as indicated. This may include selfstretching or partner stretching.
  • Inferior mobilization
  • Theraband exercises; grade of tubing and exercise disposition (concentric or eccentric) will vary according to the patient’s strength and tolerance. Startwith internal/external rotation with the elbow tucked at the patient’s side then progress to flexion/abduction to 90 degrees, extension and adduction.
  • Dumbbell exercises for the rotator cuff are implemented after satisfactory strength with therabands is observed

Clinical Follow-Up

  • The patient will follow-up weekly with therapist to supervise their home program
  • The patient will return at 6 months postop to see the physician and the therapist for measurement of strength and ROM

Phase IV: Return to Activities for Large & Massive Tears

  • Patients will continue a home exercise program
  • Focus on deficits in strength and function

**As always progression through the Phases is individualized for each patient

Book an Appointment Today

Or call 804-678-9000
Schedule Now!
Book Appointment

Richmond’s Shoulder, Hip, Knee, Foot & Ankle Specialists

Two convenient locations:

  • Glen Allen near Henrico, The West End, Hanover & Short Pump.
  • Midlothian in the St. Francis Medical Center.

Insurance Partners

See Who We Work With

Resources

  • How to Choose an Orthopedic Surgeon E-guide
  • The Baseball Guide to Injury Prevention
  • Knee and Shoulder Rehab and Exercises
  • Surgery Instructions
  • Patient Forms

Latest News

Treat Ankle Arthritis (& Other Conditions) Fast with our Specialists at G2 Orthopedics

September 23, 2020

G2 Orthopedics Welcomes Dr. Anson Chu!

August 31, 2020

Recover at Home with MotionIQ

July 2, 2020

What is Outpatient Shoulder Replacement?

May 28, 2020

Outpatient Knee Replacement Surgery: Overview & FAQ’s

May 5, 2020
Facebook-f
Linkedin-in
Youtube
Instagram
Twitter

Glen Allen Location:

Conveniently located near Nuckols Road, I-64 and 295.

Phone: 804-678-9000
Fax: 804-377-1246

100 Concourse Blvd, Suite 150,
Glen Allen, VA 23059

Midlothian:

In the St. Francis Medical Center off Charter Colony Parkway.

Phone: 804-678-9000
Fax: 804-377-1246

13700 St. Francis Boulevard, Suite 505,
Midlothian, Virginia 23114

Copyright 2019 | Privacy Policy | G2 Orthopedics And Sports Medicine | Shoulder, Hip, & Knee Specialists And Orthopedic Surgeons | Sitemap

Serving Richmond Virginia And Surrounding Areas:
Glen Allen, Hopewell, Midlothian, Henrico, Short Pump, West End, Mechanicsville, Tuckahoe, Lakeside, Innsbrook, Hanover, Chester, Chesterfield, Colonial Heights, And Petersburg.