Mr Robin Mark Seagger MBBS MSc FRCS

GMC No. 4536697

Twitter @fixmyshoulder

www.fixmyshoulder.co.uk

c/o Emma Shires

emma.shires2@bmichoice.co.uk

Tel: 01706 869025

Practice Address:

BMI Highfield Hospital

Manchester Road

Rochdale

OL11 4LZ

Tel: 01706 655121

Reverse Total Shoulder Replacement

Aims:                    

Pain relief form degenerative or post traumatic arthritis with cuff dysfunction

Rotator cuff pseudo paralysis

Sling:                     

Wear at night up to 3 weeks. Can remove as comfortable in day from 48 hrs         

External rotation as directed by operation note- depends on subscapularis repair

 

Restrictions:          

External rotation as directed by operation note- depends on subscapularis repair

Avoid elbow above shoulder level for 4weeks

0-1 week:               

Check neurovascular status and post op note

Axillary hygiene

Hand, wrist and elbow active exercises

Gentle pendulums/circles as comfortable

 

1-3weeks:              

Increase pendulums and circling range

External rotation as directed

Active assisted flexion (in internal rotation) up to 90 degrees.

Avoid abduction

Sub-maximal isometrics for deltoid and infraspinatus.

No resisted subscapularis work

3-6 weeks:             

As range and comfort improves progress to-

Active assisted exercise above 90 degrees- can use pulley.

Adjust relative to patients pre op range.

Scapular setting in neutral.

Closed chain exercises in neutral

Strat strengthening exercises- avoid over loading subscapularis

Gentle progression of external rotation through range

 

After 6 weeks:       

Active exercises through range

Start gentle stretches with ‘hands on’, pulleys, ‘hold and relax’ and self-pressure                                  

Open chain exercises

Scapular control trough range

Proprioceptive exercises

Continue to progress with strengthening programme

 

Driving:                   From 8 weeks as pain allows