Arthroscopic Anterior Stabilization Rehab
Total Shoulder Arthroplasty/ Humeral Head Replacement
Rehabilitation Protocol
[pic]
Goals:
• Pain control
• Edema control
• Protect subscapularis, rotator interval, and/or rotator cuff repairs
• Gradual restoration of motion
• Return to effective use of limb for ADLs
• Restore shoulder strength and function
Phase I (0-4 weeks postop)
Sling immobilization except for washing and clothing changes x 4-6 weeks
Exercises 5-6 times/day for 10-15 minutes each session
▪ Codmans/Pendulum exercises using ‘helper hand’ for support
▪ Wrist, Hand AROM
▪ Elbow AROM (***wait 2-3 weeks if biceps tenotomy/tenodesis)
▪ Gripping exercises
▪ Shoulder shrugs
Limits:
• FF-AAROM (supine)-limited to 120o
▪ ER to 10o only
▪ IR to chest wall
▪ Sub-maximal, pain-free deltoid, trapezius, rhomboid isometrics in neutral
ADLs with hand, wrist, elbow
Modalities as needed
Phase II (4-6 weeks)
D/C sling in general
Continue sling whenever out of home in public to protect repairs
Continue FF-AAROM (wand/pulleys)
ER - AAROM to 30º only
FF – begin supine AROM
Manual scapular stabilization exercises
Begin pain-free ER isometrics
ADLs as able hand, wrist, elbow, shoulder except lifting/carrying
Modalities as needed
Phase III (6-8 weeks)
D/C sling
Use of the limb for ADLs as tolerated except no lifting/carrying
6 weeks - begin Biceps/Triceps strengthening
Progress scapular strengthening in protective arcs
Begin limited isotonic IR/ER strengthening in modified neutral
Begin seated active FF in plane of scapula
Begin AROM for ER
Continue to increase FF AROM/PROM/AAROM
Phase IV (8-10 weeks)
Continue scapular strengthening
Advance isotonic strengthening for deltoid, trapezius, biceps, triceps and latissimus as tolerated
Begin progressive resistive exercises of deltoid and rotator cuff
Begin general flexibility exercises at 10 weeks
Phase V (10-16 weeks)
Continue to restore shoulder flexibility
Continue full upper extremity strengthening
Functional training
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