Brian T. Swanson
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In the United States, more than 500,000 rotator cuff repairs and shoulder arthroscopies are performed annually. Following surgery, physical therapy (PT) often utilizes various manual therapy (MT) and therapeutic exercise (TE) interventions. Post-operatively, accessory joint mobilizations (AJM) help to prevent adhesions and may decrease excitability of central nociceptive pathways. However, there is no consensus about the most appropriate postoperative utilization and timing of MT following surgery. Maitland describes a framework for clinical decision making that is patient-centric and focuses on frequent reassessment to guide the application of manual therapy. In this framework, comparable signs are identified at initial evaluation, and refer to any combination of pain, stiffness, and/or spasm during a specific movement. An appropriate MT technique is selected and utilized to treat the comparable sign; the comparable sign is reassessed to monitor patient response, and determine the proper progression. The purpose of this case report was to detail the assessment and clinical reasoning utilized during the treatment of a patient following arthroscopic rotator cuff repair (ARCR), with manual therapy intervention guided by the principles of the Maitland approach.
Aderibigbe, Kehinde and Swanson, Brian T., "Application Of Manual Therapy Utilizing Maitland Principles In The Rehabilitation Of A Patient Following Rotator Cuff Repair" (2016). Case Report Posters. Poster 104.