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Total Shoulder Replacement Rehabilitation Protocol

  • The time-lines mentioned are approximate and actual progression depends on individual recovery. Total recover can take 10-12 months, but significant functional gains can be expected by 12 weeks.
  • You will need to wear a sling for 4 weeks, including at night. Please remove the sling for shower and for exercises 3-5 times daily for 15-20 minutes each time.
  • Please follow the advice and exercises demonstrated by your surgeon and your physiotherapist to give yourself the best possible chance of recovery and a good outcome.
  • Your therapist will incorporate these exercises into your daily home exercise regimen.
  • We encourage Hydrotherapy commencing 2-3 weeks after surgery. The warm water and buoyancy allows for comfort and less pain during exercises and muscle relaxation.
  • Do not perform forceful exercises. Perform exercises within the limits of pain and allow for a gradual return of movements over time.
  • For the first 2 weeks – Apply icepacks 3-5 times daily for 10 minutes each time.
  • Remember to take pain medication as advised to assist with exercises and keeping you comfortable.

First 6 weeks

  • 5 times daily exercises out of sling.
  • Self-stretching shoulder exercises as per protocol.
  • Passive and gentle active-assisted forward elevation and rotations to neutral position only form the mainstay.
  • The Physiotherapist will see you in the hospital before discharge. Please follow his / her advice and the self-stretching exercises in the sheet will be incorporated in your home exercise regimen.
  • Pendulum, Stick-assisted and pulley exercises as tolerated.
  • Start scapular retraction and shoulder shrugging as soon as able.
  • Elbow, wrist and hand exercises.
  • Can start ADLs (activities of daily living like eating, writing, typing, etc.) after 2 weeks with above limitations in movement.
  • Maximum weight you can lift is a cup of tea.

6-12 weeks

  • Gradually progress with ADLs.
  • Progress with Active-assisted exercises. Can start active ROM exercises. No restrictions to range.
  • Start gentle isometric rotation and isometric deltoid exercises (only 25-30% strength).
  • Also start core strengthening and scapular stabiliser strengthening as able.

After 12 weeks

  • Start rotator cuff and deltoid strengthening exercises.
  • Progress with ROM.
  • No restrictions to activities.
  • Please remember – No forceful stretching. Allow movements and strength to return gradually.