SHOULDER-IMPINGEMENT-NONOP-PT by IanKilpatrick

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									                                                              PHYSICAL  THERAPY  PRESCRIPTION

SETH  C.  GAMRADT,  MD
ORTHOPAEDIC  SURGERY  AND  SPORTS  MEDICINE
UCLA  DEPARTMENT  OF  ORTHOPAEDIC  SURGERY
1250 16th Street, Suite 3145
Santa Monica, CA 90404
310.319.1234 Appointments                                                                       PATIENT STICKER


CA  License:  A769260
www.gamradtortho.com

Diagnosis:  (  LEFT  /  RIGHT  )    Impingement  Syndrome  Shoulder  /  Rotator  Cuff  TendoniLs  

DATE:_______________________

                                      SHOULDER  PHYSICAL  THERAPY  PRESCRIPTION

___  Range  of  MoLon    (Increase  IR)            AcLve  /  AcLve-­‐Assisted  /  Passive
___  Rotator  Cuff  and  Scapular  stabilizaLon  program  exercises,  begin  below  horizontal
___  Progress  to  45  /  90  as  tolerated  in  pain  free  arc

___  Begin  with  Isometrics  for  Rotator  Cuff  
                    Progress  to  Theraband,  then  to  Isotonics
                    Limit  ER  to  neutral  if  (+)  Biceps  TendoniLs
___  Progress  to  Deltoid,  Lats,  Triceps,  and  Biceps
                    Progress  scapular  stabilizers  to  Isotonics  below  horizontal
___  Posterior  Capsule  stretching  a[er  warm-­‐up
___  Return  to  Sport  Phase:
                    Emphasize  eccentric  Rotator  Cuff  and  scapula  stabilizaLon  exercises
                    Sport  specific  strengthening  with  Theraband
                    Plyometric  program  for  overhead  athletes
___  ModaliLes  prn  
Treatment:  ________  Emes  per  week                                      ___  Home  Program
DuraEon:  ________  weeks


Physician’s  Signature:_____________________________________________
Seth  C.  Gamradt,  MD,  AKending  Orthopaedic  Surgeon,  UCLA

								
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