2009 Mar;1(2):125-30 Avoid creating pain – discomfort is okay but pain should not occur and persist 3 days in a row. Phases and time frames are designed to give a general sense of progression. Rehabilitation Insertional Achilles Tendon Repair Rehabilitation Protocol Rehabilitation Goals: Protect the repaired tendon, recover from surgery, reduce pain and swelling, and gradually return to activities of daily living. The information is the property of Massachusetts General Hospital and should not be copied or otherwise used without express permission of the Director of MGH Physical & Occupational Therapy Services. Treatment options … 0‐14 Days Postoperative Do NOT remove the surgical bandage. 2014 2. *COLE,*MD,*MBA RANGE OF MOTION IMMOBILIZER EXERCISES PHASE I 0-6 weeks 0-3 weeks: None 3-6 weeks: Begin PROM Limit 90° flexion, 45° ER, Acute versus chronic, as well as, concomitant procedures, and physiologic age of the patient The optimal postoperative rehabilitation protocol after surgical repair of an Achilles tendon rupture is evolving from the classic routine using rigid immobilization in a below-knee nonweightbearing cast for 6 weeks with subsequent ankle range of motion (ROM) and strengthening exercises. Achilles Tendon PARS repair (pdf) . •. Tendon Repair However wound complcations such as wound breakdown or infection can occur and can be very serious. Tendon Repair Therefore, the rate of progression for post-surgical rehabilitation should vary based on the size and extent of the tear. Distal Biceps Tendon Repair – REHABILITATION PROTOCOL Michael B. Gerhardt, M.D. REHABILITATION PROTOCOL GENERAL PRINCIPLES This protocol for Achilles tendon repair is designed to provide the rehabilitation professional with a general guideline for patient care with the AlterG Anti-Gravity Treadmill. Home; Physical Therapy Protocols; Dr. Zahn PT Protocols; Achilles Tendon Repair Protocol; 0-2 weeks NWB in splint 2-6 weeks Walkabout boot gradually decreasing plantarflexion 10 degrees per week such that neutral is accomplished by 6 weeks. QUADRICEP TENDON RUPTURE- REPAIR PROTOCOL . Upper Extremity Extensor Tendon Repair Protocol Sports Health. Purpose: To systematically review various flexor tendon rehabilitation protocols and to contrast those using early passive versus early active range of motion. The primary goal of this protocol is to protect the repair while steadily progressing towards and ultimately achieving pre-injury level of activity. Tendon Pectoralis Major Tendon Repair Rehabilitation Protocol The intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient that has undergone an arthroscopic Pectoralis Major Tendon Repair procedure. Download PDF. Rehabilitation Protocol: Achilles Tendon Rupture Repair Piasecki DP, Nicholson GP. 515 Ray C. Hunt Drive, Suite 1100, Charlottesville, VA 22903 Phone: 434-243-7778 Fax: 434-243-5075 . 2 Small prospective human clinical trials 13,17,18 used early … EPL REPAIR EARLY ACTIVE MOTION Phase I Precautions: The primary goal is to protect the surgically repaired extensor tendon while providing early motion to prevent tendon adhesion. General considerations. Proximal biceps tendon repair Immediate Post op (Weeks 0-4) Weightbearing: As tolerated in hinged knee brace locked in extension Range of Motion: Increase Range of Motion as tolerated to achieve Full ROM by 8-10 weeks. Rehabilitation Protocol: Achilles Tendon Rupture Repair Department of Orthopaedic Surgery Lahey Hospital & Medical Center, Burlington 781-744-8650 Lahey Outpatient Center, Lexington 781-372-7020 Lahey Medical Center, Peabody 978-538-4267 Department of Rehabilitation Services Lahey Hospital & Medical Center, Burlington 781-744-8645 tendon repair physical therapy Protocol Please fax initial evaluation and progress notes to 815‐381‐7498. Achilles Tendon Repair Protocol. Specific changes in the program will be made by the - Initiate gentle resistive exercise with soft therapy putty. - May also add light resistive hand grippers for exercise. Phase III Precautions:It is important to remember that the client will continue to improve for 3- 6 months following tendon repair and should continue to focus on HEP until all goals have been met. Emphasis on... Rehabilitation Protocol for Distal Biceps Tendon Repair PURPOSE: To systematically review various flexor tendon rehabilitation protocols and to contrast those using early passive versus early active range of motion. J Bone Joint Surg Am. Care Injured. For residual DIP joint stiffness in extension due to ORL tightness may add manual passive assistance at 10 weeks, with the PIP joint at 0° extension while the DIP joint is actively or passively flexed. Evans, Roslyn B. “Rehabilitation Following Extensor Tendon Injury and Repair.” UW Health's Sports Medicine sports rehabilitation physical therapists and athletic trainers in Madison, Wis., help injured athletes return to health and return to sport. Patella and patella tendon mobility drills. You may come out of the sling at home, but ear it in public. 1. All zones of injury were included. • Restrictions: No heavy lifting or pulling greater than 0 lbs. The Achilles tendon is a strong, fibrous cord in the lower leg. UVA SPORTS MEDICINE . Patellar and Quadriceps Tendon Repair Rehabilitation Protocol . For the knee and leg. The 1‐‐‐‐3 Days Postoperative • Do not remove the surgical bandage. Ice and modalities to reduce pain and inflammation. Patellar Tendon Debridement & Repair Rehabilitation Protocol PREOPERATIVE PHASE Goals: • Diminish inflammation, swelling, and pain • Restore normal range of motion (especially knee extension) • Restore voluntary muscle activation • Provide patient education to … 1998 This protocol provides you with general guidelines for initial stage and progression of rehabilitation according to specified time frames, related tissue tolerance and directional preference of movement. It helps you walk, run, and jump. May start WBAT with brace locked in extension . Rehabilitation Protocol for Distal Biceps Tendon Repair This protocol is intended to guide clinicians through the post-operative course for distal biceps tendon repair. The patient is to begin active and passive range of motion of the uninvolved fingers and thumb to prevent stiffness and reduce swelling. Rehabilitation Protocol for Quad and Patellar Tendon Repair Rehabilitation Guidelines: Summary Table Post –op Phase/Goals Therapeutic Exercise Precautions Phase I 1 - 2 weeks after surgery Goals: Control pain and swelling Initiate knee motion Activate Quad Phase II 2 – 6 weeks after surgery Heel Slides Ankle pumps Achilles tendon. A systematic review of early rehabilitation methods following a rupture of the Achilles tendon. Dr. Gerhardt will make final determination). Distal Biceps Tendon Repair Rehabilitation Protocol. Achilles Tendon Repair Rehabilitation Protocol The following is a protocol for post-operative patients following Achilles tendon repair. Journal of Hand Therapy 1989; 2 (4):223‐30. All zones of injury were included. Rehabilitation following Achilles tendon repair is vital in regaining motion, strength and function. There is tearing of tendon Physical Therapy Distal Bicep Tendon Repair- Rehabilitation Protocol The intent of this protocol is to provide the clinician with a guideline of the post-operative rehabilitation course for a patient that has undergone a distal biceps tendon repair. Long term results of acute Achilles repair with triple-bundle technique and early rehabilitation protocol. Physical Therapy Guidelines for Peroneal Tendon Repair This was written and developed by the therapists of MGH Physical Therapy Services. The intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient that has undergone a quadriceps or patellar tendon repair. Am J Orthop. Hand Rehabilitation Protocols | 3 If you have any questions or concerns, please call 859-562-1980. It is by no means intended to be a substitute for one’s clinical decision-making regarding the progression of a patient’s postoperative course based on their physical exam/findings, … Methods: We searched PubMed and Cochrane Library databases to identify articles involving flexor tendon injury, repair, and rehabilitation protocols. Functional outcome is directly related to size of the tear4. Initial Visit: Dressing change . Rehabilitation Protocols. Department of Orthopaedic Surgery sports Medicine and Shoulder Service Baumgarten KM1, Vidal AF, Wright RW.Rotator Cuff Repair Rehabilitation: A Level I and II Systematic Review. Clin Sports Med. Post-operative Rehabilitation Protocol. Physical Therapy Protocol Gluteus Medius Repair (+/- Arthroscopic Labral Repair) The intent of this protocol is to provide guidelines for your patient’s therapy progression. A variety of protocols for flexor tendon rehabilitation have been developed over the past 50 years, making the choice of which protocol to use difficult. Increase 10˚/week until full range of motion is achieved. Specific changes in the program will be made by the Initially a walking boot is used for the first 4–5 weeks. Injury. There are normally two options for repairing an Achilles tendon rupture. Achilles tendon repair and rehab (pdf). We request that the PT/PTA/ATC should use appropriate clinical decision-making skills when progressing a patient. 2008. Sean Rockett, MD . No driving. See video, Supplemental Digital Content 2, which outlines The Saint John rehabilitation Protocol for the first 2 weeks after flexor tendon repair with 3 to 5 days of immobilization and elevation followed by passive warm ups and up to half a fist of early protected true active finger flexion. Appointments should be 2 times per week until integrity has been determined and Development of an accelerated functional rehabilitation protocol following minimal invasive Achilles tendon repair. METHODS: We searched PubMed and Cochrane Library databases to identify articles involving flexor tendon injury, repair, and rehabilitation protocols. This protocol is time based (dependent on tissue healing) as well as criterion based. Electromyographical assessment of passive, active assistive, and active shoulder … [Google Scholar] Stone RG, Spencer EL, Almquist EE. All zones of injury were included. This protocol provides you with general guidelines for initial stage and progression of rehabilitation according to specified time frames, related tissue tolerance and directional preference of movement. Extensor Tendon Repair Zones II, III, IV Rehabilitation Protocol Kelly Holtkamp, M.D. Triceps Tendon Repair Rehabilitation Protocol Kelly Holtkamp, M.D. Additional restrictions or modifications will be listed in the last paragraph of the Operative Report and the therapy instructions. Patellar tendon repair with allograft post-operative physical therapy protocol. Extensor Tendon Repair Zones V, VI Rehabilitation Protocol 1‐3 Days Postoperative Do not remove the surgical bandage. Achilles Tendon Repair – Rehab Guidelines Protocol: Brian Grawe, MD Progression is based on healing constraints and functional progression specific to the patient. 21 A firm understanding of the timing of these phases is important to safely individualize rehabilitation protocols after rotator cuff repair. *COLE,*MD,*MBA WEIGHT BEARING BRACE ROM EXERCISES PHASE I 0-2 weeks As tolerated with crutches and brace*** Locked in full extension for sleeping and all activity* Off for exercises and hygiene 0-2 weeks: 0-45° when non-weight bearing Heel … 50% weight bearing for 3 weeks. Physical Therapy Protocols osms 2022-03-03T10:33:10-06:00. Kocaoglu B, Ulku TK, Gereli A, Karahan M, Turkmen M. 2015;43(8):1957-1964. Subscapularis Repair Rehab Protocol Prescription. Restrictions: No heavy lifting or pulling greater than 0 lbs. 250 South Main St. Suite 224A Blacksburg, VA 24060 540-552-7133 Postoperative Phase I (24 hours to 3-4 weeks) 1. Am J Sports Med. N2 - Purpose: To systematically review various flexor tendon rehabilitation protocols and to contrast those using early passive versus early active range of motion. SUBSCAPULARIS REPAIR REHABILITATION PROTOCOL ! Distal Bicep Tendon Repair Protocol . Methods: We searched PubMed and Cochrane Library databases to identify articles involving flexor tendon injury, repair, and rehabilitation protocols. 4. Primary Upper Extremity and Hand Extensor Tendon Repair Protocol This protocol is not intended to be a substitute for one’s clinical decision making regarding the progression of a patient’s post-operative course based on their physical exam/findings, Please fax initial evaluation and progress notes to 815 ‐‐‐‐381 ‐‐‐‐7498 . Start P.T. Pectoralis Major Tendon Repair Rehabilitation Protocol Flexor tendon injuries can be challenging, especially in zone II. For more information go to www.rehab-3.com References Kaar MD, Cutuk MD. Distal Biceps Tendon Repair Rehabilitation Protocol-Brigham and Women's Hospital. Sean Rockett, MD . ... Failure to repair an Achilles tendon injury can lead to weakness in push-off strength and the possibility of a repeat rupture. 1 . 90° initially then gradually increase during first 2 weeks • Shoulder PROM ER/IR @ 45° ABD to tolerance (caution w/ excessive ER) As such, it should be stressed that this is only a protocol and should not be a substitute Brace locked at 0 degrees for ambulation for 6-8 weeks with use of bilateral axillary crutches. Anterior Cruciate Ligament !his gi"es 2– 6 weeks- You people arning that they on#t bump into you, etc. Quadriceps tendon repair post-operative protocol These rehabilitation guidelines are criteria based. DISTAL BICEPS TENDON REPAIR PROTOCOL PG. Range of motion – 0° to 30°knee flexion. Braunstein, Mareen et al. Phase I: Initial Post-Operative Immobilization (Days 0-7) Elbow is immobilized in brace selected by surgeon; Phase II: Mobility Phase (Weeks 2-8) The surgical leg will be weight bearing as tolerated using crutches post-operatively. Flexor tendon repair rehabilitation protocols: a systematic review. The Saint John Protocol describes a rehabilitation program of up to half a fist of protected true active finger flexion beginning 3 to 5 days after flexor tendon repair. COPYRIGHT*2014*CRC*©"BRIAN*J. Brumann, M., Baumbach, S. F., Mutschler, W., & Polzer, H. Accelerated rehabilitation following Achilles tendon repair after acute rupture-Development of an evidence-based treatment protocol. A strong repair using at least a 4-strand core suture and an associated epitendinous suture will allow for early rehabilitation, which can minimize the risk of adhesion formation. PERONEAL TENDON REPAIR REHABILITATION PROTOCOL Based on protocol of Sigvard Hansen, M.D., Harborview Medical Center Rehabilitation Phase III (12-20 weeks post-operative) Criteria to Progress to this Phase Patient progressing with decreased pain and edema Patient progressing with AROM Patient is comfortable with full weight bearing Journal of Hand Surgery ‐ American Volume 2013; 38 (A):1712‐17. It is not intended to serve as a recipe for treatment. If it does, rest the patient until pain level is clearly decreasing. Uhl TL, Muir TA, et al. Distal Biceps Tendon Repair Rehab Protocol 1 Rehabilitation Guidelines - Distal Bicep Tendon Repair Note: Revision surgery or cases involving allograft procedures may undergo modifications to the below guideline. ACHILLES TENDON REPAIR SURGERY REHABILITATION PROTOCOL PREOPERATIVE INSTRUCTIONS Here are guidelines that will help you in preparing for surgery to repair your Achilles tendon: BEFORE SURGERY: Dr. Gill will see you in the office. Gradually more weight bearing and mobility is allowed to prevent stiffness post-operatively. Applicability: Physician Practices Date Effective: 09/2013 Department: Rehabilitation Services Date Last Reviewed: 1/2021 Phase I: 1-3 weeks Clinical Goals ♦ Elbow ROM from 30º of extension to 120º of flexion (this may vary depending on patient’s situation. It is not intended to be a substitute for one’s clinical decision making regarding the 27: 731-745. 2. Rehabilitation Protocol Achilles tendon repair ... Achilles tendon repair surgery is carried out to treat Achilles tendon rupture. Restrictions: No heavy lifting or pulling greater than 0 lbs. Specific intervention should be … 2. Wean off crutches at 4 weeks. DISTAL BICEPS TENDON REPAIR- Endobutton REHABILITATION PROTOCOL RANGE OF Posterior Splint THERAPEUTIC MOTION EXERCISE PHASE I Begin active/passive flex Remain in splint and sling Gentle wrist and shoulder ROM 0 - 2 weeks and active extension Begin A/P pronation and sup in splint 8 times per day Rehabilitation Protocol . Brace locked in full extension for 6 weeks. Distal Biceps Tendon Repair Patient Instructions Emilie Cheung, M.D. Rehabilitation Protocol: Quad and Patellar Tendon Repair Department of Orthopaedic Surgery Lahey Hospital & Medical Center, Burlington 781-744-8650 Lahey Outpatient Center, Lexington 781-372-7020 Lahey Medical Center, Peabody 978-538-4267 Department of Rehabilitation Services Lahey Hospital & Medical Center, Burlington 781-744-8645 After tendon repair, several rehabilitation protocols are used with the objective of finding a balance between active exercise (to prevent tendon adhesions) and immobilization (to … at 2-3 weeks . Tears of the subscapularis tendon in athletes-diagnosis and repair techniques. First 2 weeks after flexor zone 2 tendon repair. Boyea, BL and Machen, MS: Posterior Tibial Tendon Reconstruction (FDL Transfer and Calcaneal Osteotomy): William Beaumont Army Medical Center, Physical Therapy Section, August 2008 Churchill, R and Sferra, J: Posterior Tibial Tendon Insufficiency, It’s Diagnosis, Management and Treatment. 20. •. Achilles tendon repair surgery is a type of surgery to fix a damaged Achilles tendon. UW HEALTH SPORTS REHABILITATION UWSPORTSMEDICINE.ORG 621 SCIENCE DRIVE • MADISON, WI 53711 4602 EASTPARK BLVD. It’s the largest tendon in your body. Injury, Int J. Surgical repair of the Achilles tendon offers a lower re-rupture rate (0-4%), a greater chance of returning to sports, greater strength, and more endurance. 75% weeks 3-4. 2014; 45:1268-1274. Rehabilitation Protocol: Achilles Tendon Repair Name: _____ Date: _____ Diagnosis: _____ Date of Surgery: _____ Flexor Tendon Repair Therapy Protocol 1 of 5 Bart Eastwood D.O. Bevoni, R. et al. Insertional Achilles tendon repair (pdf). COPYRIGHT*2014*CRC*©BRIAN*J. A grade 2 strain is a moderate strain. PATELLAR TENDON REPAIR REHABILITATION PROTOCOL ! Rehabilitation Protocol Triceps Tendon Repair Phase I: Protect Repair (0 to 2 weeks) • Precautions o Elbow immobilized in posterior splint at 60° elbow flexion for 1st 2 weeks o No active elbow extension 6 weeks • ROM o Gradual ↑ Active/Passive ROM of shoulder in all planes while in splint o Wrist/hand/finger full AROM in splint Patellar and Quadriceps Tendon Repair Rehabilitation Protocol . Achilles Repair Rehabilitation Protocol Key considerations: 1. Orthopedic Surgery Stanford Hospital and Clinics 1 st 1-2 weeks - Sling. Avoid all passive motion into DF for 1st 6 weeks post-op 3. Rehabilitation Program Following Proximal Biceps Tendon Repair Shoulder Brace: wear for daily activities & sleeping for 4 weeks Range of motion Week 1-2 • Shoulder PROM flexion approx. Rehabilitation following Achilles tendon repair is vital in regaining motion, strength and function. Initially a walking boot is used for the first 4–5 weeks. Gradually more weight bearing and mobility is allowed to prevent stiffness post-operatively. The rehabilitation progresses slowly into strengthening, gait and balancing activities. Immediate Post op (Weeks 0-4) Weightbearing: As tolerated in hinged knee brace locked in extension Range of Motion: Increase Range of Motion as tolerated to achieve Full ROM by 8-10 weeks. The protocols listed below were developed by Southeast Georgia Health System physicians and therapists and are intended for use by clinicians and patients alike. If it does not decrease, have doctor evaluate. The rehabilitation progresses slowly into strengthening, gait and balancing activities. Peroneal and Tibialis Posterior Tendon Repairs . Weeks 0-4. Achilles Tendon Repair Rehabilitation Protocol Timeframes for rehabilitation phases are a guide only and should be adapted to each individual patient’s progress, surgeon’s orders and with preference to err on the side of caution. Insertional Achilles Tendon Repair Rehabilitation Protocol Home » Patient Education » Insertional Achilles Tendon Repair Rehabilitation Protocol This protocol provides you with general guidelines for initial stage and progression of rehabilitation according to specified time frames, related tissue tolerance and directional preference of movement. Quad Tendon/Patellar Tendon Repair . Achilles Tendon Repair Post-op Rehabilitation Protocol . Phase 1: 0-2 weeks post-operatively Goals • Protect repair • Minimize pain • Minimize swelling • Plan to begin physical therapy and/or home exercise program 1-3 days after surgery : Brace/Crutch • MADISON, WI 53718 Rehabilitation Guidelines for Distal Bicep Tendon Repair The elbow is a complex system of three joints formed from three bones; the humerus (the upper arm bone), the ulna (the larger bone of 2005; percutaneous Achilles tendon repair techniques during a simu- 87(10):2202-2010. lated, progressive rehabilitation protocol. At 2-3 weeks home E-stim unit (if needed) for quadriceps muscle re-ed. It connects the muscles of your calf to your heel. Key points. Rehabilitation Guidelines for Rotator Cuff Repair Type I PHASE III (begin after meeting Phase II criteria, usually post-op weeks 8-12) Appointments • If AROM deficit is present with lag signs surgeon should be notified re: concerns about repair integrity. ♦ Maintain minimal swelling and soft tissue healing Tear size (large/massive tear or >1 tendon repair difficult to achieve full ROM, caution with AROM and resisted exercises with chronic/large tears). Range of motion will be blocked at 0 degrees in a brace for 4 weeks. An evaluation of early motion management following primary flexor tendon repair: Zones 1‐3. 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