Shoulder Arthroscopy Rehab Protocol
- .Use of a sling for 1-2 weeks post-op unless otherwise indicated.
- Maintenance of good postural positioning when performing all exercises.
- Aerobic conditioning throughout the rehabilitation process.
- M.D. follow-ups Day 1, 4 weeks, 3 months, 6 months and 1 year.
- All active exercises should be carefully monitored to minimize substitution or compensation.
Week 1
- Nurse visit day 2 to change dressings and review home exercise program.
Manual
- Soft tissue mobilization to surrounding tissues, effleurage for edema.
- Passive range of motion in all planes as tolerated.
Exercises
- Elbow flexion and extension, wrist and forearm strengthening.
- Cervical stretches, scapular squeezes, lower trap squeezes.
- It is important to come out of the sling frequently to bend and straighten elbow for 10-15 repetitions each time to minimize arm and hand swelling
- Well-body cardiovascular exercise (stationary bike, elliptical without arms, stairmaster).
Goals
- Decrease pain and edema.
- Passive range of motion flexion, scaption to 90 degrees, external rotation to 30 degrees.
Weeks 2 - 4
- Nurse visit for stitch removal at Day 14.
Manual
- Continue soft tissue treatments, passive range of motion, scapula glides, light joint mobilizations as tolerated
- Pain control (i.e. cryotherapy, massage, electric stimulation).
Exercises
- Begin isometrics in all planes
- Initiate active range of motion in all directions as tolerated.
- Scapular strength training exercises with theraband.
- General conditioning as tolerated (include trunk flexion & extension exercises).
Goals
- Decrease pain and edema.
- Passive range of motion flexion, scaption to 120 degrees, external rotation to 60 degrees.
- Active range of motion flexion, scaption, abduction to 90 degrees with good mechanics.
Weeks 4 - 6:
Manual
- Continue as needed for soft tissue, fascial, and joint mobility.
Exercise
- Progress strength training exercises including weight bearing exercises, theraband exercises, and gym exercises.
Goals
- Full passive/active range of motion
Weeks 6 - 8
Manual
- Continue as needed for soft tissue, fascial, and joint mobility.
Exercise
- Continue to advance rotator cuff strengthening in multiple planes of movement (wall ball dribbling, step ups/downs in plank, prone scapular strengthening with weights).
- Initate light throwing type activities.
Weeks 8+
- Initiate sport specific training as tolerated with no pain.
- Continue strengthening, endurance training, and overall fitness.
All progressions are approximations and should be used as a guideline only. Progression will be based on individual patient presentation, which is assessed throughout the treatment process.
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