Use of Myofascial Release and Proprioceptive Neuromuscular Facilitation in Combination with a Rehabilitation Protocol for a Patient following a Massive Rotator Cuff Tear and Repair: A Case Report

Background and Purpose. This case report describes the use of postoperative treatments incorporating myofascial release and proprioceptive neuromuscular techniques, on a 59-year-old male who underwent a left open rotator cuff repair following a massive rotator cuff tear. This was after an 8 week passive motion phase. The goals of this case report were to evaluate the feasibility of these techniques and to examine improvements in shoulder range of motion, function of the involved extremity, and pain reduction. Case Description. The patient suffered a massive rotator cuff tear at work after falling on his shoulder. The patient started with an 8 week passive motion treatment phase combined with stretching to protect the surgical sites and allow the rotator cuff tendons to heal. At 8 weeks the patient started an active assistive range of motion treatment phase to work on strengthening and flexibility. At 10 weeks he was able to do active range of motion and began strength exercises to help strengthen the deltoid and rotator cuff muscles. Intervention. Myofascial release was used to stretch out tight restrictive tissues. The patient also performed a proprioceptive neuromuscular facilitation (PNF) hold-relax technique for external rotation. Outcomes. Visual analog pain scores (0-10) at examination, 8 weeks, and 12 weeks were 6, 3, and 1, respectively. Passive shoulder flexion, abduction, and external rotation increased by 95°,55° and 40°, respectively. At 12 weeks the patient was able to do some overhead activities at 90 degrees and was able to put on and take off his coat. Discussion. The findings suggest that myofascial release and a PNF hold-relax technique may be incorporated into a rehabilitation program for a rotator cuff tear and repair