Post Surgical Shoulder
Shoulder surgeries, whether for rotator cuff repair, labral tears, or shoulder replacement, are often necessary to restore functionality and relieve pain in patients with severe shoulder conditions. However, post-surgical rehabilitation plays an equally vital role in achieving optimal recovery. This article outlines the goals, phases, and physiotherapy strategies for effective post-surgical shoulder rehabilitation.
Understanding Post-Surgical Shoulder Rehabilitation
After shoulder surgery, the joint undergoes a healing process requiring structured physiotherapy to regain strength, mobility, and functionality. Post-operative care varies depending on the type of surgery performed, but the overarching goals remain similar:
- Minimize pain and inflammation.
- Restore range of motion (ROM).
- Strengthen the shoulder muscles.
- Gradually return to functional and recreational activities.
Physiotherapy Plan for Post-Surgical Shoulder Rehabilitation
Post-surgical shoulder rehabilitation is a structured and phased approach tailored to the type of surgery performed, such as rotator cuff repair, labral repair, or shoulder replacement. Below is a detailed physiotherapy plan to ensure a safe and effective recovery.
Phase 1: Immobilization and Early Recovery (Weeks 0–6)
Goals:
- Protect the surgical site.
- Minimize pain and inflammation.
- Prevent stiffness in adjacent joints.
Interventions:
- Immobilization:
- Wear a sling or brace as prescribed by the surgeon.
- Pain Management:
- Cryotherapy (ice packs) to reduce swelling and discomfort.
- Passive Range of Motion (ROM):
- Pendulum Exercises: Gentle circular arm movements with minimal effort.
- Therapist-assisted movements to maintain joint flexibility.
- Scapular Mobility:
- Scapular retraction exercises to prevent stiffness.
- Adjacent Joint Movement:
- Gentle exercises for the wrist, elbow, and hand to maintain mobility.
Phase 2: Range of Motion Restoration (Weeks 6–12)
Goals:
- Gradually restore ROM without overloading the joint.
- Begin light muscle activation.
Interventions:
- Active-Assisted ROM:
- Use a pulley system or the opposite hand to assist shoulder movements.
- Gentle forward flexion and external rotation exercises.
- Isometric Strengthening:
- Begin static exercises for the deltoid and rotator cuff without shoulder movement.
- Stretching:
- Passive stretching for the shoulder to prevent contractures.
Phase 3: Strengthening and Stability (Weeks 12–16)
Goals:
- Improve muscle strength and endurance.
- Restore stability to the shoulder joint.
Interventions:
- Resistance Band Exercises:
- External and internal rotation.
- Shoulder flexion and abduction.
- Weight-Bearing Exercises:
- Wall push-ups for gentle strengthening.
- Scapular Stabilization:
- Prone Y and T raises for the trapezius and rhomboids.
- Progressive Strengthening:
- Increase resistance or weight as tolerated.
Phase 4: Advanced Strengthening and Functional Restoration (Weeks 16–24+)
Goals:
- Return to pre-surgery activity levels.
- Achieve dynamic shoulder stability.
Interventions:
- Dynamic Strengthening:
- Overhead exercises with resistance bands or light weights.
- Medicine ball exercises for functional strength.
- Plyometric Training:
- If required for sports, include plyometric drills like ball throws.
- Sport or Job-Specific Tasks:
- Simulate activities specific to the patient’s goals (e.g., throwing for athletes).
Home Exercise Program
- Scalene stretches: 2–3 times daily to improve shoulder mobility.
- Shoulder pulley exercises: 2 sets of 10 repetitions.
- Light resistance band work: 10–15 repetitions for rotator cuff strengthening.
Follow-Up and Monitoring
- Regular reassessments by the physiotherapist to monitor progress.
- Adjustments to the plan based on patient feedback and recovery speed.
- Ensure adherence to the surgeon’s post-operative protocol.
By adhering to this plan, patients can recover safely and return to their desired activities with improved shoulder function and reduced pain.
