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    Shoulder Surgery

    Uploaded by

    Tirumala Rao
    This document outlines a protocol for patients following shoulder surgery including rotator cuff surgery, shoulder stabilization procedures, and labral repairs. It details guidelines for four phases of recovery with focus on pain control, range of motion exercises, and strengthening exercises.

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    © All Rights Reserved
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    Shoulder Surgery

    Uploaded by

    Tirumala Rao
    8 views3 pages
    This document outlines a protocol for patients following shoulder surgery including rotator cuff surgery, shoulder stabilization procedures, and labral repairs. It details guidelines for four phases of recovery with focus on pain control, range of motion exercises, and strengthening exercises.

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    © © All Rights Reserved

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    This document outlines a protocol for patients following shoulder surgery including rotator cuff surgery, shoulder stabilization procedures, and labral repairs. It details guidelines for four phases of recovery with focus on pain control, range of motion exercises, and strengthening exercises.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    8 views3 pages

    Shoulder Surgery

    Uploaded by

    Tirumala Rao
    This document outlines a protocol for patients following shoulder surgery including rotator cuff surgery, shoulder stabilization procedures, and labral repairs. It details guidelines for four phases of recovery with focus on pain control, range of motion exercises, and strengthening exercises.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 3

    Protocol for Patients Following Shoulder Surgery- Rotator Cuff Surgery,

    Shoulder Stabilization Procedures, Labral Repairs.

    Phase I

    0-2 weeks

     Most important concern is pain control, protection and personal hygiene.


     Patients are instructed in proper showering, dressing and ADL.
     Precautions are stated in post op instructions (given to patient after surgery)
    depending on what was done at surgery and the quality of the tissue/repair.
     Patients should sleep with immobilizer and not take any chances.
     Elbow, forearm, wrist and digits are mobilized to avoid stiffness and minimize
    edema at the elbow and hand.
     Grip strengthening by using a “squeezy ball” keeps muscle pump going to reduce
    dependent edema.
     Patients are seen at approximately 2 weeks for suture removal and wound check.

    2-4 weeks

     No significant changes are made.


     Prescription is given for PT to start depending on what was done.
    o No tissue repair just arthroscopic debridement- start at 2 weeks.
    o Tissue repaired (any method) but good quality- start at 4 weeks.
    o Tissue repaired but concerns about tissue integrity- start physician guided
    exercises at 4 weeks, formal PT at 6 weeks.

    Phase II

    Begins when patient meets and begins working with therapist (usually at 4 weeks but
    may be as much as 6 weeks post op) and lasts up till about 10-12 weeks post op

     May discontinue sling/immobilizer unless needed out of the house or for comfort.
     May sleep without sling.
     May begin driving as soon as safe and confident (usually determined by patient).
     Therapy is 3 sessions a week for 4 weeks at a time.
     Patients are encouraged and instructed in daily home stretches to assist therapist
    in achieving functional ROM.
    Motion

     Consists of AAROM with gentle passive assist by therapist to improve ROM and
    function.
     Directions include forward flexion, abduction, IR, ER.
     UBX, pulleys, cane stretches are all acceptable means to achieve ROM.

    Strengthening

     No isometrics (they generate very high tension which may disrupt tissue repair).
     Begin distally with grip strengthening, elbow flexion/extension PRE’s with light
    hand held weights.
     For proximal muscle strengthening think 3 P’s (in sequence).
    o Primary joint stabilizers.
    o Peri-scapular muscles.
    o Power movers.
     Strengthening begins lightly and increases over time as tissue heals.
     Work muscle groups in proper sequence.

    Phase III

    10-12 weeks through 6 months

    Strengthening

     Continues as before with progression to power movers and peri-scapular muscle


    strengthening.
     Anterior and middle deltoids are key to success and proper shoulder function.

    Phase IV

    6 months until back to normal.

    SLAP Repair

    For Patients who have undergone SLAP repair, use guidelines and timeframe for small
    cuff tear with good quality repair and tissue (i.e., start formal PT at 4 weeks) with
    following exceptions:

    o Avoid abduction/ER coupled motion for the first 6 weeks post-op.


    o Avoid biceps resistance exercise for 8 weeks post-op.
    Shoulder Stabilization procedures

    Capsular plications, capsular shifts, Bankharts (whether open or arthroscopic) use


    guidelines and timeframe for small cuff tear with good quality repair and tissue (i.e.,
    start formal PT at 4 weeks) with following exceptions:

     Avoid abduction/ER-coupled motion for the first 6 weeks post-op; at 6-week


    point, slowly progress this coupled movement over next 4 weeks. Full abd/ER
    allowed 10 weeks post-op.
     Go slow with ER at side – limit to 30 degrees at side for 6 weeks; at 6-week
    point, progress ER at side over next 4 weeks.
     For open repair, must violate the subscapula, therefore, as a general principle –
    protect subscapula.

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