Pain after large rotator cuff repair

[milenchen]

Hi there, I have a patient who is now 11 weeks post large rotator cuff repair with Ac excision and repair of the long head of biceps, the patient has been consistently increasing in range and I recently started him on light resisted theraband exercises after two weeks of isometric exercies. His head of humerus is quite protracted so we have been doing quite a bit of working on scapular setting. So far so good, until a few days ago when he was rubbing his shoulder with some moisturiser (!) he felt a sudden sharp, electrical current type pain down his arm which caused him very severe pain for a couple of days, he states he was unable to move his arm at all for the best part of 2 days but it started to feel better today, I saw him today and he was showing signs of impingment on flexion, abduction and external rotation with sharp pain on all these movements at about 1/2 range, pain originating around the surgical incision and down the anterior deltoid. I must add that this guy had a massive rotator cuff tear for three years before undergoing surgery. I have advised him to rest until the pain settles and avoid all exercises apart from passive assisted range of movement. Any suggestions on management and possible sources of pain? Thanks!

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[PhysioDevon]

Hi milenchen,

Do you have a rehab protocol that you have used with this patient? When is their next consultant review?