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Post-operative physiotherapy rehabilitation in rare combined full thickness tear of supraspinatus and subscapularis tendon managed by arthroscopy with mini open Supraspinatus tendon repair: A Case report

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Swapna Jawade,Swapna Jawade,

Abstract

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.Conclusion: In this case used rehabilitation protocol had significantly reduce the pain and tenderness, improved ROM , muscle strength and endurance which helped patient to restore his functional independence at home and work.

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