Beginner Cervical Spine Tendon Repair Rehabilitation

Pain at rest < 3/10 on Visual Analog Scale,Active cervical range of motion limited to pain-free ranges (flexion/extension, lateral flexion, rotation),No neurological signs: no radicular symptoms into upper extremities, no motor weakness in deltoid, biceps, triceps,Incision/surgical site healing without signs of infection,Cervical collar or immobilization device tolerated as prescribed,Patient demonstrates understanding of activity restrictions and spinal precautions

→ Advance to: Early Mobility Phase

Pain at rest < 2/10, pain with movement < 4/10,Cervical active range of motion: flexion > 30°, extension > 20°, lateral flexion > 20° bilaterally, rotation > 45° bilaterally,No reproduction of neurological symptoms with neck positions,Deep cervical flexor muscle activation observed (craniocervical flexion test > 30mmHg pressure biofeedback),Scapular stabilization exercises tolerated without exacerbation,Tolerance of 30-minute upright posture without increased symptoms

→ Advance to: Intermediate Strengthening Phase

Cervical ROM: flexion > 45°, extension > 35°, lateral flexion > 30° bilaterally, rotation > 60° bilaterally,Deep cervical flexor endurance > 30 seconds in neutral position,Cervical paraspinal muscle strength grade 4/5 (semispinalis, multifidus),No provocation of symptoms with resistance exercises up to 2kg,Shoulder girdle strength > 4/5 for scapular stabilizers (serratus anterior, lower trapezius, rhomboids),Patient reports return to basic ADLs without increased symptoms

→ Advance to: Advanced Strengthening Phase

Full pain-free cervical ROM (flexion 50°, extension 60°, lateral flexion 45°, rotation 80°),Cervical flexor and extensor strength > 4+/5 on manual muscle testing,Deep cervical flexor endurance > 60 seconds,No symptoms with sustained postures > 2 hours,Tolerance of functional activities including overhead reaching,Neck Disability Index score improvement > 15% from baseline

→ Advance to: Return to Function Phase

Full cervical ROM equal to contralateral side,Cervical muscle strength 5/5 for flexors, extensors, lateral flexors, rotators,Return to work-related activities if applicable,No exacerbation of symptoms with high-repetition or resistance exercises,Patient confidence in cervical spine loading tasks,Progressive return to recreational activities as tolerated

→ Advance to: Discharge/Independent Maintenance

Pain-free full functional ROM of cervical spine,Normal cervical muscle strength and endurance,Independent with home exercise program,Neck Disability Index score < 20% (minimal disability),Patient reports satisfaction with functional outcome,No restrictions for return to pre-injury activities

→ Advance to: Discharge