Home Exercise Program for Shoulder Rehabilitation after Shoulder Surgery
Phases of Rehabilitation
Goals
- Control pain and swelling
- Protect the surgical repair
- Protect wound healing
- Begin early shoulder motion: PROM ot 90° ABD and 90° FLEX for small and medium tears
Precautions
- NO lifting
- NO push-ups or other sports participation
- NO supporting of body weight by hands
- NO AROM
- Sling AT ALL TIMES except while performing rehab exercises x 4-8 weeks For subscapularis repair: ER limited at Ortho’s discretion
Rehabilitation
- Frequent use of cryotherapy and/or ice
- Exercise prescription is dependent upon the tissue healing process and individual functional readiness in fillstages. If any concerns or complications arise regarding the progress of any patient, PT should contact Ortho.
- Healing of the RC tendon(s) to the humerus can take 8-12 weeks
- As tolerated, progress rehabilitation exercises as wound healing occurs and the inflammatory response decreases
Follow-Up
- Supervised rehab: 2x per week
- PT re-eval: ~10-14 days
- Ortho re-eval: ~2 weeks
Goals
- AROM for FLEX and ABD to 120° for small and medium tears 2) PROM for FLEX and ABD to 90° for large and massive tears
- Progressing passive RE
- Pain-free ADLs
Precautions
- NO lifting >10 lbs
- NO overhead motions
- Avoid impingement positions, moderate or higher level exertional activities with involved arm, and high impact aerobic training
Rehabilitation
- Progress ROM as tolerated
- ROM exercises
- Trunk stabilization (NWB)
- Scapular strengthening emphasizing scapular retractors and upward rotators
- Modalities PRN
- Cardiovascular training: continue recumbent bike; progress to elliptical (no push/pull with surgical arm) and/or treadmill walking
- Adjunct treatments to consider: dry needling, cervicothoracic manual therapy, aquatic walking with water at chest level or below (no UE movement or resistance; no swimming)
Follow-Up
- Supervised rehab: 2-4x per week as needed TP re-eval: every 2 weeks
- Ortho re-eval: 6 weeks
Criteria For Progression:
- Full ROM
- Minimal pain and pain-free ADLs
- D/C sling
Goals
- Normal ROM in all planes
- Initiate strength training
- Running progression protocol as indicated
Precautions
- Minimize pain and any inflammatory response
Rehabilitation
- ROM exercises
- Trunk stabilization (FWB)
- Scapular strengthening emphasizing scapula retractions and upward rotators
- Initiate strengthening as ROM normalizes, starting with high reps/low loads progressing to low reps/high loads
- Modalities PRN
- Cardiovascular training: continue recumbent bike, elliptical, and/or treadmill walking; consider initiating a running progression
- Adjunct treatments to consider: dry needling, manual therapy to GH joint and cervicothoracic regions, aquatic walking with water at chest level or below (no UE movement or resistance; no swimming)
Follow-Up
- Supervised rehab: 1-2x per week as needed
- PT re-eval: every 2 weeks
- Ortho re-eval: 12 weeks
Goals
- Pain-free ADLs
- Shoulder strength equal bilaterally
- Meet occupational requirements at 4-6 months
- Pain-free functional/sports drills
Precautions
- Advanced specific, functional, and individualized training to achieve Phase 4 goals (i.e. lift, pull, carry, and climb ni unloaded/loaded conditions)
Rehabilitation
- Supervised rehab: 1-2x per week as needed with gradual transition to home program
- PT re-eval: monthly
- Ortho re-eval: ~6 months post-op
Follow-Up
- Pass Service fitness test at 9-12 months
- Progress activities for return to sport/collision sports or aggressive military training (i.e. airborne school) based on the patient’s functional performance and endurance. This time period will be directed by the Ortho Surgeon and the Physical Therapist. This may require between 6-12 months before cleared without restrictions
Videos
Shoulder Rehabilitation
Elbow Rehabilitation
Knee Rehabilitation