Hi all,

I have an 84 year old male patient who is 6 months post-surgery for a very severe Rot Cuff traumatic injury. Repair of all Rot Cuff tendons, capsulotomy, AC jt excision and non-repaired rupture of LHB. His humeral head is anteriorly placed approx. 1.5 cm > opposite. I saw this patient 5 months post-op and he had a lot of scar tissue and adhesions, hiking of the shoulder in all movements, an altered scapulohumeral rythmn, muscle atrophy and weakness; AROM: ABD=30 Flex=25 HZ ADD 10% ER=45 IR=35 PROM: ABD=70 FLEX=40. The patient is compensating with overactive traps. His scapula is abducted with some dynamic winging.
So far I have used Passive ROM EXS, Periph & Accessory GH Jt Mobs, AAROM EXS in supine, pulley, UL ergometer, Scap setting and resistive band work for Rot Cuff. However, despite some improvement (his PROM in ABD = 90, Flex 50 improved scaphum rythmn) his AROM is progressing so slowly!

Any advice or thoughts would be much appreciated.

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