Our Summary

This review paper looks at the current research and ideas about rehabilitation for patients with front-of-shoulder instability injuries and surgical repairs. Right now, there isn’t much research about physical therapy for these types of shoulder injuries and repairs, leading to different approaches by surgeons and physical therapists. While there’s some agreement on certain aspects of rehab, there’s still not enough evidence showing the importance of rehab and specific performance tests for preventing future injuries and returning to sports. The paper emphasizes that rehab after these types of shoulder injuries and repairs is crucial. It can help restore flexibility to soft tissues, stabilize the shoulder joint, and improve balance and strength, all of which may protect the healing tissues and possibly lower the risk of future injuries or recurrences.

FAQs

  1. What does the current research say about rehabilitation for front-of-shoulder instability injuries and surgical repairs?
  2. Why is there lack of agreement among surgeons and physical therapists on the rehabilitation approach for these types of shoulder injuries?
  3. How can rehabilitation after shoulder injuries and surgical repairs help in the future prevention of injuries?

Doctor’s Tip

One helpful tip a doctor might tell a patient about labral repair is to follow their physical therapy and rehabilitation program diligently. This program is crucial for restoring strength, flexibility, and stability to the shoulder joint after surgery, and can help prevent future injuries or complications. It’s important to communicate with your physical therapist and follow their guidance to ensure the best possible outcome from your labral repair surgery.

Suitable For

Patients who are typically recommended labral repair are those who have sustained a labral tear in the shoulder joint. This injury can occur due to trauma, overuse, or repetitive movements. Labral repair may be recommended for patients who have persistent shoulder pain, instability, decreased range of motion, and weakness in the shoulder. Additionally, patients who have tried conservative treatments such as physical therapy and cortisone injections without success may be candidates for labral repair surgery. It is important for patients to undergo a thorough evaluation by a healthcare provider to determine if labral repair is the most appropriate treatment option for their specific condition.

Timeline

Before labral repair:

  1. Patient experiences pain, instability, and limited range of motion in the shoulder.
  2. Patient undergoes diagnostic imaging (such as MRI) to confirm the presence of a labral tear.
  3. Patient consults with an orthopedic surgeon to discuss treatment options, including labral repair surgery.
  4. Patient undergoes pre-operative physical therapy to strengthen the shoulder muscles and improve range of motion.
  5. Patient undergoes labral repair surgery to repair the torn labrum.

After labral repair:

  1. Patient begins post-operative physical therapy to regain strength, range of motion, and stability in the shoulder.
  2. Patient wears a sling to protect the shoulder and allow for proper healing.
  3. Patient gradually progresses through physical therapy exercises to increase strength and range of motion.
  4. Patient undergoes follow-up appointments with the surgeon to monitor healing and progress.
  5. Patient gradually returns to normal activities, including sports, under the guidance of the surgeon and physical therapist.

What to Ask Your Doctor

  1. What is the expected recovery timeline for labral repair surgery?
  2. What restrictions or limitations will I have post-surgery, and for how long?
  3. What type of physical therapy will be recommended after surgery?
  4. How soon after surgery can I begin physical therapy?
  5. What exercises or activities should I avoid during the recovery period?
  6. Will I need any special equipment or assistive devices during the rehabilitation process?
  7. What are the signs of complications or setbacks that I should watch out for during recovery?
  8. How will we know if the surgery was successful, and what are the potential outcomes?
  9. Are there any specific goals or milestones I should aim for during the rehabilitation process?
  10. How long should I expect to be out of work or away from sports and physical activities following labral repair surgery?

Reference

Authors: Ma R, Brimmo OA, Li X, Colbert L. Journal: Curr Rev Musculoskelet Med. 2017 Dec;10(4):499-506. doi: 10.1007/s12178-017-9449-9. PMID: 29038953