Abstract

Background: Complete combined disruption of muscle fibres of Supraspinatus
and subscapularis tendon are rare than any other tear of rotator cuff. Mini open
arthroscopy supraspinatus tendon repair is used to repair a torn supraspinatus along with
other tendon that forms rotator cuff. Prime aim of post-operative physiotherapy
rehabilitation following arthroscopy mini open supraspinatus tendon repair (STT) is focus
on healing of repaired tendon when reducing muscle atrophy and stiffness due to
prolonged immobilization. In this case study Rehabilitation protocol has been modified
into four phases from immediate protection phase to advance strengthening exercises on
the basis of surgery procedure.
Case Presentation: A 41 year male who was diagnosed with combined full thickness tear of
supraspinatus and subscapularis tendon which are rare than any other tear of rotator cuff.
Patient underwent arthroscopy with mini open supraspinatus tendon repair (STT) after 20
days .Patient was referred to physiotherapy with complaints of pain, restricted range of
motion (ROM), muscle weakness and difficulty in functional activities. Rehabilitation was
given according four phases to accelerate early healing of repair tendon. Patient was
treated 5 days per week for 22 weeks. In Phase I patient was explained maintain the arm in
abduction sling for 5 week, removed only during exercises and no lifting of objects or
taking body weight. Key exercises of rehabilitation were therapeutic modalities to reduce
pain (cryotherapy, Interferential therapy) scapula isometrics, range of motion,
strengthening exercises, muscle energy technique (MET) with open-chain proprioceptive
activities.