Shoulder Rehabilitation

Arthroscopic Posterior Stabilisation

Sling When will I go home? What can I do? What can’t I do?
4 weeks in external rotational brace You will be discharged on the same day as the operation Passive range of movement in safe zone* No forced movements, no combined forward flexion/internal rotation. No lifting
If combined anterior and posterior stabilisation, please use this rehabilitation protocol.

 

Acute phase (0-4 weeks)

Goals

  • Protect surgical repair
  • Reduce pain
  • Commence controlled shoulder range of movement
  • Promote improved proprioceptive acuity

Rehabilitation

  • *Safe zone: aim for passive range of movement to 90° elevation, 45° abduction, 0° external rotation by end of second week
  • Active assisted/supported range from 2 weeks
  • No forced movements/stretch, no combined forward flexion/internal rotation
  • Closed kinetic chain/proprioception exercises
  • Cuff exercises within the safe zone
  • Scapular setting exercises
  • Elbow, wrist, hand exercises

Criteria for progression

  • Controlled pain
  • Adequate range of movement (need adequate rotational range of movement before introducing active through range cuff facilitation work above 90°)
  • Compliance with exercises

Intermediate phase (4-8 weeks)

Goals

  • Discard sling
  • Gradual/progressive restoration of functional range of movement
  • Re-educate cuff recruitment and scapular control through range
  • Enhance proprioception
  • Preserve surgical repair integrity

Rehabilitation

  • No passive stretching into combined forward flexion/internal rotation
  • Encourage active movement with good control and without apprehension
  • Engage cuff and scapular stabilisation
  • Proprioceptive exercises
  • Progress cuff & scapular recruitment through range
  • Hydrotherapy permitted
  • Progress kinetic chain integration
  • Closed kinetic chain work

Criteria for progression

  • Painfree functional range of movement
  • Good cuff and scapular control through functional range

Late phase (>8 weeks)

Goals

  • Restore full range of movement
  • Optimise preparatory and reactive stabilisation
  • Optimise cuff and scapular control under load
  • Enhance shoulder power, strength and endurance

Rehabilitation

  • Regain optimal range of movement into combined positions
  • Enhance neuromuscular control through range and incorporated with kinetic chain
  • Aim for visible hypertrophy of posterior cuff, trapezius and serratus
  • Strengthening and endurance exercises for cuff and scapular musculature
  • Preparatory and reactive stabilisation drills in risk positions

Guidelines for return to functional activities

Driving Lifting Swimming Golf
6-8 weeks Light lifting 4 weeks. Avoid heavy for 3 months Breaststroke 6 weeks, freestyle 12 weeks 3-6 months

SHOULDER SPECIALIST

Mr. Devinder Garewal

MBBS, BMedSci, FRACS (Orth), FAOrthA

Mr. Devinder Garewal is an orthopaedic shoulder specialist. Devinder completed his medical qualifications from the University of Melbourne and is a Fellow of the Royal Australasian College of Surgeons and the Australian Orthopaedic Association.

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Shoulder Joint

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Elbow Joint

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Wrist Joint

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Hand Joints

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