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Rockwood Exercises
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Rockwood Exercises - February 17, 2001 8:41:00 AM
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britchez
Posts: 1
Joined: February 16, 2001
From: wichita, ks, usa
Status: offline
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This may seem a bit silly but I'm attempting to add one more bit of proof to a stubborn PA for a orthopod about this subject. So as not to persuade or "lead" anyone I will just ask that you please respond to the following question.
If someone were to ask you to describe Rockwood exrcises of the shoulder what would you tell them or how would you describe them?
Thanks everyone!! I'll be in touch after we cause the PA's face to turn red with the final tally.
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Re: Rockwood Exercises - February 17, 2001 10:42:00 AM
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Andrew M. Ball, MS, PT
Posts: 500
Joined: October 8, 1999
From: Chapel Hill, NC, USA
Status: offline
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Britchez
According to Pape et al. The Rockwood procedure is a capsulorrhapy surgical technique that is used for capsulorrhaphy treatment of multidirectional shoulder instability with anterior dislocation. It involves refixation of the Bankart lesion with transosseous suture and double breasting of the anterior capsule.
The only reference to what could be loosly defined as "Rockwood exercises" is that all patients in the study were followed up with a "functional rehabilitation program without immobilization." Sounds to me that just about any form of functionally driven rehabilitation (e.g. most physical therapy in general) would qualify as a Rockwood exercise.
It seems to be a realtively sucessful surgical procedure. Postoperatively 59% (n = 44) were able to take part in sports without restrictions, 27.4% could take part only in sports not involving the shoulder, and 13.5% (n = 10) did not engage in any sports postoperatively. The redislocation rate was 12.3% (n = 9), and there was 1 traumatic redislocation. A deficit in abduction/elevation by 10-60 degrees was found in 4 patients (5.4%) and by > 60 degrees in 2 patients (2.7%).
In addition, Rockwood himself published an article on the subject of "modified Neer acromioplasty, subacromial decompression, and debridement of massive, irreparable lesions of the supraspinatus and infraspinatus tendons." He noted that, "An unsatisfactory outcome was observed in shoulders in which the anterior part of the deltoid muscle was weak or absent or in which a previous acromioplasty and attempted repair of the rotator cuff had been performed." Strengthening of the anterior deltoid could therefore be considered an impairment level exercise treatment protocol, or "Rockwood exercise".
That brings me to a word I've not used since the first grade . . . duh!
Gee, that's a tough one to figure out on your own isn't it? If the shoulder joint is dislocating to the anterior, who WOULDN'T strengthen the anterior deltoid? So far, I'm not to impressed with the magic and mystery of "Rockwood exercises."
Burkhead WZ & Rockwood CA, however, describe treating patients with a "specific set of muscle-strengthening exercises". It is the only article I was able to find regarding a specific muscle strenthening program endorsed by Rockwood . . . but he's not the primary author, making the exercises more appropriately termed "Burkhead exercises".
Once you've purchased and reviewed the Burkhead article, (you can order one for under $15 online from [URL=http://www.medportal.com]www.medportal.com[/URL] if no medical center is available in your area . . . or the PA may himself/herself subscribe to the journal in question), I'm sure we'd all be interested in hearing exactly what the Burkhead protocol entails.
Respectfully,
Andrew M. Ball, MS, MBA, PT
References:
Pape HC, et al. [Rockwood capsulorrhaphy in shoulder instability. A clinical follow-up study]. Unfallchirurg. 1995 May;98(5):289-95.
Rockwood CA, et al. Debridement of degenerative, irreparable lesions of the rotator cuff. J Bone Joint Surg Am. 1995 Jun;77(6):857-66.
Burkhead WZ, Rockwood CA. Treatment of instability of the shoulder with an exercise program. J Bone Joint Surg Am 1992 Jul;74(6):890-6
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