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Shoulder arthroscopy rehab protocol

General Considerations

  • .Use of a sling for 1-2 weeks post-op unless otherwise indicated.
  • Maintenance of good postural positioning when performing all exercises.
  • Aerobic conditioning throughout the rehabilitation process.
  • M.D. follow-ups Day 1, 4 weeks, 3 months, 6 months and 1 year.
  • All active exercises should be carefully monitored to minimize substitution or compensation.

Week 1

  • Nurse visit day 2 to change dressings and review home exercise program.

Manual

  • Soft tissue mobilization to surrounding tissues, effleurage for edema.  
  • Passive range of motion in all planes as tolerated.

Exercises

  • Elbow flexion and extension, wrist and forearm strengthening.
  • Cervical stretches, scapular squeezes, lower trap squeezes.
  • It is important to come out of the sling frequently to bend and straighten elbow for 10-15 repetitions each time to minimize arm and hand swelling
  • Well-body cardiovascular exercise (stationary bike, elliptical without arms, stairmaster).

Goals

  • Decrease pain and edema.
  • Passive range of motion flexion, scaption to 90 degrees, external rotation to 30 degrees.

Weeks 2 - 4

  • Nurse visit for stitch removal at Day 14.

Manual

  • Continue soft tissue treatments, passive range of motion, scapula glides, light joint mobilizations as tolerated
  • Pain control (i.e. cryotherapy, massage, electric stimulation).

Exercises

  • Begin isometrics in all planes
  • Initiate active range of motion in all directions as tolerated.
  • Scapular strength training exercises with theraband.
  • General conditioning as tolerated (include trunk flexion & extension exercises).

Goals

  • Decrease pain and edema.
  • Passive range of motion flexion, scaption to 120 degrees, external rotation to 60 degrees.
  • Active range of motion flexion, scaption, abduction to 90 degrees with good mechanics.

Weeks 4 - 6:

Manual

  • Continue as needed for soft tissue, fascial, and joint mobility.

Exercise

  • Progress strength training exercises including weight bearing exercises, theraband exercises, and gym exercises.

Goals

  • Full passive/active range of motion

Weeks 6 - 8

Manual

  • Continue as needed for soft tissue, fascial, and joint mobility.

Exercise

  • Continue to advance rotator cuff strengthening in multiple planes of movement (wall ball dribbling, step ups/downs in plank, prone scapular strengthening with weights).
  • Initate light throwing type activities.

Weeks 8+

  • Initiate sport specific training as tolerated with no pain.
  • Continue strengthening, endurance training, and overall fitness.

NOTE: All progressions are approximations and should be used as a guideline only. Progression will be based on individual patient presentation, which is assessed throughout the treatment process.

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