The other day a patient asked me if he should exercise his shoulder before getting a shoulder replacement. Regular exercises to restore motion and flexibility to your shoulder and a gradual return to your everyday activities are important for your full recovery after shoulder surgery. Rehab after total shoulder replacement physical therapy. Shoulder replacement this handout has information about your reverse total shoulder replacement and the exercises you will need to do after your surgery. Your shoulder is a ball and sockettype joint made up of two main parts. Rehabilitation guidelines for shoulder arthroplasty and. Charles neer ii is quoted as saying shoulder replacement will fail without adequate rehabilitation. In hemiarthroplasty the socket may be recontoured or resurfaced but a plastic socket replacement is not used. Each case can be very different depending on the goals of the patient, the age of the. The shoulder is a ball and socket joint that enables you to raise, twist, bend and move your arms forward, to the sides and behind you. Rehabilitation guidelines for standard reverse total. This is done to start to allow your shoulder to hang freely from your body. Total shoulder arthroplasty hemiarthroplasty protocol.
Gradual increase of activities from supine to vertical i. Stretching exercises this handout illustrates some basic range of motion exercises for the shoulder. Remember the following as you engage in phase 1 shoulder replacement rehab exercises. This is because the articular surface of the round. Rehabilitation after reverse total shoulder replacement phase 4. Aarom wand exercises including flexion, supine and standing, er to neutral, extension. The intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient that has undergone a total shoulder arthroplasty tsa or hemiarthroplasty humeral head replacement, hhr. Most patients are very comfortable and functional after 3 months. Maximizing your new shoulder university of florida. Minimize heavy, excessive cyclic loads for the first 6 months.
The first exercise often recommended after a total shoulder replacement is a gentle pendulum exercise. To protect, repair and maintain your range of motion, it is. Emphasize progression in supine rotator cuff program c. Your orthopaedic surgeon and physical therapist may recommend that you exercise for 10 to 15 minutes, 2 or 3 times a day during your early recovery period. Rehabilitation guidelines for shoulder arthroplasty and reverse ball and socket arthroplasty the anatomic configuration of the shoulder joint glenohumeral joint is often compared to that of a golf ball on a tee. Mathes about shoulder replacement surgery shoulder replacement surgery is a major operation. Emphasize flexion and er to limit determined in or d. Total shoulder replacement rehabilitation guidelines. When arthritis affects the shoulder it causes the lining of these. Physical therapy for reverse total shoulder replacement. There are medications for arthritis, exercises, and physical therapy and occupational therapy that can be done to help conservatively manage. A little background, the patient is about 60 years old and is an avid weight lifter. Maintain surgical motion early, but protect subscapularis repair by avoiding.
Do not move the arm away from body unless fully sup. This can help the muscles around the surgical site to relax a bit and can get some muchneeded range of motion in your shoulder joint. Total shoulder replacement protocol sports and orthopedic. Paff the intent of this protocol is to provide the clinician with guidelines of the postoperative rehabilitation of someone undergoing total shoulder arthroplasty or hemiarthroplasty. Modifiedempty can exercise, performed with thumb pointed up, well below shoulder level limit patients shoulder elevation below 60 70 degrees d. Electromyographic analysis of specific exercises for scapular control in early phases of shoulder rehabilitation. It is not intended to be a substitute for appropriate. Early post surgery rehab first 6 weeks after surgery. Use of a sling for 3 weeks postop unless otherwise indicated. Reverse shoulder replacement delta3 rotator cuff repair. It can take up to 12 months 1 year to achieve the final result of a reverse total shoulder replacement.
Please aim to do the following exercises 34 times per day. It is not intended to be a substitute for appropriate clinical decisionmaking regarding the progression of a patients postoperative. After your recovery, these exercises can be continued as a maintenance. The head of the upper arm bone humerus is the ball and a circular depression glenoid in the shoulder bone scapula is the socket. This video series demonstrates the stages of rehabilitation you are likely to experience following a total shoulder replacement tsr.
Johns hopkins shoulder surgery arthroscopic acromioplasty. One recently developed method of general rehabilitation, total motion release, may be beneficial in restoring. They should be performed within your comfort zone unless otherwise instructed. Unless your doctor feels that you have adhesive capsulitis or frozen shoulder, these exercises should not cause pain. Shoulder replacement surgery was first performed in the united states in the 1950s to treat severe shoulder fractures.
You will be shown exercises by the physiotherapist. Isotonic strengthening exercises should be encouraged 12xweek for 36 months b. Variances will be communicated by the surgeon directly to rehabilitation services. If you do too much and your shoulder is sore, reduce your activity until it settles and then gradually build up again exercises all of these exercises are safe for you to do, as long as you follow the instructions. Rehabilitation protocol for total shoulder arthroplasty. Shoulder examination tests 15032020 diagnose your shoulder this is an interactive guide to help you find relevant patient information for your shoulder problem. Resume functional activities as allowed by the physician this protocol provides you with general guidelines for the rehabilitation of the patient with a reverse total shoulder replacement. Rehabilitation protocol for reverse shoulder arthroplasty. However, shoulder implants can loosen, parts can wear and rarely, a device does break. Total shoulder replacement arthroplasty for shoulder arthritis total shoulder replacement arthroplasty is a wellestablished surgery for restoring comfort and function to the arthritic shoulder. Glenohumeral joint replacement and postoperative rehabilitation. Reverse total shoulder arthroplasty rtsa is designed for the treatment of glenohumeral gh arthritis when it is associated with irreparable rotator cuff tears,complex fractures, severe glenoid deformity from dysplasia or wear, or for a revision of a previously failed conventional total shoulder arthroplasty tsa.
The rehabilitation program will gradually progress to more strengthening and control type exercises. Victoria bc v8z 0b9 tel 250 940 4444 fax 250 385 9600 page 1 june 2017 v1s. Physical therapy for reverse total shoulder replacement this handout has information about your reverse total shoulder replacement and the exercises you will need to do after your surgery. This shoulder conditioning program should be continued for 4 to 6 weeks, unless otherwise specified by your doctor or physical therapist. Postshoulder replacement surgery exercises ucsf health. No ube exercises no abduction stretching or strengthening.
Grasp onto the towel with your hand on your low back and use your other arm to pull your hand up your spine until a stretch is felt on the back of your shoulder. Rehabilitation after reverse total shoulder replacement. The eclipse system has been used successfully to treat primary and posttraumatic osteoarthritis, and has been supported by several clinical publications in the journal of shoulder and elbow surgery, including a thorough 9year prospective cohort that began in 2005. Perform all above exercises without weights 10 repetitions, 1 2 times daily, progressing to 10. An electromyographic evaluation of subdividing activeassistive shoulder elevation exercises. Supine exercises should be done with a small rolled towel placed behind the elbow to avoid shoulder hyperextension and anterior capsular stretch. Maintenance of good postural positioning when performing all exercises. Restore shoulder strength to allow activities of daily living 4. Sling is to be worn full time outside of the home and sleeping for 23 weeks, prn in the home may vary by m. Over the years, shoulder joint replacement has come to be used for many other painful conditions of the shoulder, such as different forms of arthritis. Elbow, wrist and hand mobility after your shoulder surgery, it is important to maintain full mobility of the joints below the affected shoulder. Reverse total shoulder replacement sports and orthopedic. Total shoulder replacement oct 2009 sunnybrook hospital. Continue to protect the repair by avoiding excessive forceful use of the arm or lifting excessively heavy weights.
Joint replacement sports medicine reverse total shoulder arthroplasty protocol weeks allow healing of soft tissue, monitor neurovascular status independent with adls with modifications to protect joint replacement. Total shoulder arthroplastyhemiarthroplasty protocol. There is no guarantee that shoulder replacement will make you painfree. Shoulder replacement surgery replaces damaged joint surfaces with artificial parts prostheses. To protect, repair and maintain your range of motion, it is important for you to do the following during this time period. Rehabilitation after total shoulder arthroplasty dr.
When shoulder replacement surgery is performed, the ball is removed from the top if the humerus, or your upper arm bone, and replaced with a metal implant. General time frames are given for reference to the average. The material presented here is for informational purposes only and is not intended to serve as an exercise program. Rehabilitation program following humeral head replacement or total shoulder replacement 4 4. The following exercises may be recommended by your doctor and should be performed as instructed.
Exercises for recovery from total shoulder replacement. In this procedure the arthritic ball is replaced by a smooth metal ball fixed to the arm bone humerus by. Elevation motion and strengthening is to be performed in the scapular plane. Shoulder replacement surgery may involve only the replacement of the ball the head of the humerus, see. Shoulder replacement rehabilitation program johns hopkins. All exercises should be done 3 to 5 times a day as your pain allows. You may feel pressure on the front of your shoulder while performing this stretch due to capsular tightness deep in the back of your shoulder. Loosening, wear or breakage of the artificial shoulder the goal of shoulder replacement is to reduce pain and restore function. Shoulder abduction use cautionavoid increase in subacromial pain c. Reverse total shoulder replacement rehabilitation guidelines. Postshoulder replacement surgery exercises after your shoulder replacement operation, it is important to perform certain exercises to help strengthen your shoulder and arm and encourage recovery. Indicates the patients diagnosis and rehab category, which falls into two main groups. Total shoulder arthroplasty tsa involves both replacement of the ball head of the. Physical therapy rehabilitation following total shoulder.
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