Surgery for Traumatic Instability of the Shoulder.
Last updated Thursday, February 10, 2005
RehabilitationWhat is a typical rehabilitation program after surgery for traumatic instability of the shoulder? Patients are usually able to conduct their own postoperative
rehabilitation program with instructions from a physical therapist or a
physician.
Vigilance must be exercised for patients over 35 years of age to be
sure that they do not develop unwanted postoperative stiffness. Thus,
particularly for these patients, the three-week and six-week checks are
very important to make sure that the ranges of elevation and external
rotation are respectively 90 and 0 degrees at three weeks, and 140 and
40 degrees at six weeks. What are typical rehabilitation instructions given to a patient after surgery for traumatic instability of the shoulder? These are typical instructions given to a patient after a repair for
traumatic instability. However, the program will vary with the surgeon,
the patient, and the repair. If you have had such a repair, only your
surgeon can give you instructions on the postoperative management. Do
not do any exercises after surgery except after consultation with your
physician.
After your surgical repair, your arm is in a sling to assure that it
heals properly. If this sling is not comfortable, be sure to let your
doctor know immediately.
You may remove your arm from the sling to perform your exercises.
These include lying down on your back and lifting your arm so that the
elbow points straight up. In the second exercise, also performed lying
on your back, you rotate your forearm away from your stomach until it
points straight ahead.
You need to start exercises in your sling right away. First you need
to maintain the strength of your grip by squeezing a ball, sponge, or
putty several hundred times a day. Second you should perform three
minutes of gentle isometric exercises at least three times a day
against some fixed object - pushing your wrist outward, pushing your
hand forward, pushing your elbow outward, and pushing the elbow back.
These exercises are designed to maintain your muscle tone. The shoulder
is not moved during these exercises. They should be comfortable.
You will return to the office three weeks after surgery. If
everything is healing properly, you will begin weaning yourself from
the sling at that time.
At three weeks after surgery, you can increase your overhead reach
until your arm is close to your ear and until your forearm can be
externally rotated 40 degrees from the straight ahead position. You
need to continue your previous isometric exercises and can add internal
and external rotation strengthening using rubber tubing.
You then progress by using your arm for light activities of daily
living, avoiding the positions that used to be unstable. Always avoid
"checking" your shoulder to see if it is stable. You must not lift over
10 pounds for the first six months after your surgery.
After six weeks you can begin gentle, well-controlled, repetitive
activities with your shoulder such as swimming or using a rowing
machine, provided that these activities are comfortable for you.
At three months it is often appropriate to implement the full home exercise program.
You cannot return to contact sports or heavy work for at least three
months after this surgery, and then only if you have excellent strength
and coordinated control of your shoulder.
If you have any questions at any time, please let your doctor know.
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