Outpatient Physical Therapy Management for a Full Thickness Sutraspinatus Tendon Tear: A Case Study

Background and Purpose. This article describes the 14-week physical therapy treatment of a pre- and postoperational full thickness supraspinatus tendon tear of a 45-year-old female. The four muscles of the rotator cuff provide stabilization to the glenohumeral joint of the shoulder. These muscles are the supraspinatus, infraspinatus, teres minor, and the subscapularis. l In the United States, roughly 460 000 rotator cuff repair surgeries occur each year and they are the second most common orthopedic procedure. 2 Past research studies have shown that a full recovery from this surgery takes 3 to 6 months, with factors such as integrity of tendons, extent of injury, and commitment to rehabilitation playing a role in the length of recovery. 3 The purpose of this case report is to describe the interventions implemented with a patient with a supraspinatus tear and the responses to them. Case Description. This patient is a 45-year-old female that fell from a hammock onto an outstretched arm, which resulted in a full thickness supraspinatus tendon tear. The patient underwent a repair with a autogenous bicep\u27s tendon, which resulted in a 14 week physical therapy treatment. She was extremely motivated and had an excellent support system. The patient had a full recovery and was back to her prior level of function by the end of therapy. Intervention. The freafinent for this patient included passive range of motion, active assistive range of motion, active range of motion, stretching, blood flow restriction training, and strengthening. Outcomes. Following PT intervention, the patient achieved full active range of motion for all shoulder motions, symmetrical strength bilaterally, decreased pain, and improved symmetrical shoulder alignment with movement. The patient was able to return to work full time with limited pain, sleep throughout the night, and complete overhead tasks for short periods of time. Discussion. Rationale for treatment followed Michelotti\u27s Arthroscopic Partial Articular Surface Rotator CuffRepair Physical Therapy Protocol for rotator cuff injuries. I The patient responded very well to our passive stretching in the beginning and blood flow restriction training towards the end of her therapy. I believe this was the case because of how tense her shoulder was after immobilization, that the passive stretching was the only way to increase her range of motion at that time. BFR was utilized to aid in the strengthening process