Torbay Cuff Protocol
Torbay Cuff Protocol
Torbay Cuff Protocol
• Patient education
• Posture correction
• Re-education of muscle recruitment
• Strengthening
• Stretching
• Improving proprioception
• Adaptation
Patient education
Patients should be given a thorough explanation of what has happened to
their shoulder and why their function is impaired. Time should be spent re-
assuring the patient that whilst pain in the shoulder does not correlate with
harm, there is little to be gained by using the shoulder to the extent that it
becomes more irritable. Patients should also be made aware of the goals of
the rehabilitation programme because no progress will be made if the patient
fails to engage with the process. Realistic and achievable goals should be
set.
Posture correction
Posture correction is felt to be important in order to optimise glenoid position
and sub-acromial space. Many of these patients have stiff, kyphotic thoracic
spines and so expectations must be realistic.
Strengthening
Strengthening of the anterior portion of deltoid and the teres minor muscle are
a critical element of the rehabilitation programme.
Stretching
Disuse and degenerative changes frequently lead to stiffness in the shoulder
and so gentle stretches within the limits of pain should be encouraged.
Improving proprioception
Activities that encourage weight bearing through the limb are important as
there is usually proprioceptive deficit.