Total Shoulder Replacement Rehabilitation

 

Therapist Information

  • The Subscapularis Muscle will have been detached and re-attached as part of the operation. This is why the range of motion in external rotation may be limited for a time.
  • With this limit it is still important to start to move the shoulder as soon as possible as pain allows.
  • Many of the muscles will not have been used for some time due to pain and stiffness. Rehabilitation may therefore be slow.
  • Please check the operation note for full details of the procedure performed.

 

Before Discharge

Day 1:

  • Vacuum drain removed from wound.
  • There will be a dissolving stitch in the wound with paper stitches and a dressing over the top.This may be changed.
  • You may shower with the dressings on but do not immerse the wound in water for 2 weeks. The paper stitches will peel off easily. No stitches need to be removed.
  • Start gentle exercises to prevent elbow and wrist from becoming stiff.

 

Day 2 (approx):

  • Xrays to confirm implant position
  • Start exercises for the shoulder
  • No Active Internal Rotation
  • External Rotation to the limit set in the Operation Note only
Figure 1 Figure 2 Figure 3 

 

 

Day 3-5

  • Start Isometric Cuff strengthening if tolerated. No internal rotation

 

 

 

Figure 1 Figure 2  Figure 4

 

 

Discharge: When comfortable. This is usually 3-6 days.

 

Discharge to 3 weeks

  • Start Passive Abduction Exercises
  • Start External Rotation to neutral
  • Start Active assisted flexion in supine progressing to sitting if possible

 

3-6 Weeks

  • Outpatients appointemnt at 3 weeks to check the wound.
  • Formal physiotherapy usually starts at 4 weeks
  • Start to work on all range including Internal and External Rotation
  • If pain allows and range is good then progress to strengtheing with a theraband (this may weel not start until 12 weeks)

 

Figure 1 Figure 2 Figure 3

 

 

Late Stage

Continue to work on range and strengthen as tolerated

Progress is very individual and will depend on a number of preoperative factors incuding

  • The severity of the arthritis
  • The condition of the muscles
  • The stiffness of the joint

 

Improvement can be seen for up to 18 months following surgery