shoulder Archives | Jeremy M. Burnham, MD

Bone & Joint Clinic of Baton Rouge | Sports Medicine

  Contact : (225) 766-0050

All Posts Tagged: shoulder

SLAP Repair Protocol (Types II & IV)

*Adapted from James Bradley, MD

WEEKS 0-4 (Patient Responsibility):

Range of motion exercises should be performed starting the day after shoulder surgery; exercises are to be done 3 – 4 times a day, 15 repetitions each. The sling may or may not

need to be removed to exercise (depending on the brand). A portion of the exercise program requires the assistance of a friend or a family member.  This period of limited activity is critical for the healing of the soft tissues and promoting a shoulder without instability.

WEEKS 4-10 (Formal Physical Therapy Initiated):

  • Progressive passive range-of-motion to full, as tolerated in all planes
  • Begin passive posterior capsular and internal rotation stretching
  • Begin passive and manual scapulothoracic mobility program
  • Begin external rotation in abduction exercises
  • Begin protected biceps, rotator cuff and scapular stabilizer strengthening
  • Allow use of operative extremity for light activities of daily living
  • Discontinue sling and abductor pillow at 6 weeks

WEEKS 10-16:

  • Begin biceps, rotator cuff and scapular stabilizer resistance exercises
  • Begin sport-specific exercise program

WEEKS 16-24:

  • Continue stretching and strengthening programs with special emphasis on posterior capsular stretching

WEEKS 24-36:

  • Continue and complete Interval Throwing Program (Phase I, II, & III for pitchers; Phase I & II for infielders, outfielders and catchers)
  • Continue strengthening and posterior capsular stretching indefinitely. Occult posterior capsular tightness had a significant role in the original SLAP lesion; stretching this area will limit the chances of recurrence.
  • Return to sport at nine months if cleared by Dr. Burnham.

Complete Throwing Program booklet provided through this office.

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PRP – Platelet Rich Plasma

Overview of PRP

Of all the orthobiologic treatments, PRP has turned out to be the early star in the sports medicine world. It is affordable, low-risk, and effective. Platelet Rich Plasma (PRP) is derived from one’s own blood, and contains a supraphysiologic concentration of platelets, healing enzymes, and growth factors. Although platelets are usually thought of in the context of the clotting process of blood, PRP contains many biologic elements which are crucial to healing (VEGF, FGF, IGF, PDGF, and TGF). In general, tendons and other soft tissues have a poor blood supply, and this can limit their ability to heal. An injection of concentrated PRP can provide healing growth factors to the injured area (imagine one month’s worth of healing nutrients in a single injection).

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