Total Shoulder Replacement

​

Aims:                     

Pain relief form degenerative or post traumatic arthritis

​

Sling:                     

Wear at night up to 3 weeks. Can remove as comfortable during day from 48 hours

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

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