Exercise Regime
It is important to start moving the elbow stretching it out straight and moving the hand normally immediately after surgery. The physiotherapist will come to your hospital bed and help you move the arm passively up to approx. 90 degrees. This will be performed by the therapist for you, so not using your own muscles initially.
You will be given an exercise sheet which will give you the normal regime for the type of operation you have had.
You will feel some discomfort while doing the exercises. If the pain is very severe or lasts more than 30 minutes after the exercises, then you may need to change what you are doing. This is best discussed with your physiotherapist.
You can use ice and painkillers before you start the exercises to reduce the pain. You can repeat the ice after if needed.
Exercises are best done little and often around 4-5 times a day for 5-10 minutes
Gradually increase the number of repetitions that you do.
After 3–4 weeks you can increase the length of time exercising.
Early Phase 1 Exercises
These are performed from Day 1 to Day 14
1. Pendular exercises
Standing holding on to something stable. Then lean well forwards and let the arm swing to and fro forwards and backwards. Do 20 times
Then in the same position move it in and out x20
Then do a small circle one way and then the other way
2. Shoulder shrugs
Standing shrug your shoulders up and forwards and then back and down.
Try and get your shoulder blades to come together in your back as you roll the shoulders down.
Repeat 10 times
3. Double arm lift in lying
Lift up both arms up towards the bed head. You can help the bad arm up with your good hand or you can hold a stick
Try and do this with your elbows straight but if unable to then start with the elbows bent x 10
Progress to arms straight.
4. Shoulder rotation in lying
Lying down hold the walking stick with your elbows bent.
Keep your elbow by your side and push the stick towards your bad side to help move the shoulder in to rotation. Just ease into this movement gently and repeat x 10
5. Shoulder flexion with a pulley
You can set up a pulley system over the door or attached to a coat hook on the door.
Sit or stand and pull down with your good arm to help raise the bad on up x 10
6. Shoulder flexion in sitting
Slide your arm out straight across the table x10
Week 2 – 6 weeks
Phase 2- Continue any of the other exercises that still need work.
Then add in the following:
7. Shoulder flexion to 90 degrees then small circles
Lie on your back- Raise your arm up with the help of the other one to 90 degrees
Once the arm is up there try and hold it there. If you are able to do that try and do small circles in the air with the hand x 10 each way
8. Half arm lifts
Lift your arm up to vertical position with the elbow bent. Gradually try and lower this half arm towards the bed and back up again x 10
9. Stretches
Standing do some stretches-
Firstly put your bad arm behind your back and try and pull it down towards your opposite buttock x 5
10. External Rotation in sitting with a stick.
Place a rolled towel under the arm. Keep your elbow tucked in onto the roll. Now try and help the arm rotate outwards gently.
11. Internal rotation
Then try and stretch it up your back towards your neck x 5
You can add in holding a towel exercise where you hold a towel behind your back with one hand behind the back and the other behind the neck . Then pull up with the arm behind the neck to try and ease the other one further up the back.
Then swap hands and put bad arm behind neck and try and pull it downwards with the other arm via the towel.
12. Then Pull the arm across your body towards the opposite shoulder x5
13. Gentle resisted muscle exercises- Lateral rotation
Firstly stand next to a wall sideways with your elbow bent and push your hand in to the wall. Hold for 10 secs and repeat 5 times
14. Resisted Abduction
In the same position but this time push your elbow in to the wall. Hold and repeat x 5
15. Resisted extension
Stand with your back to the wall and with the elbow bent push back in to the wall. Hold 10 secs and repeat x 5
16. Resisted flexion
Now facing the wall with your elbow bent push your fist in to the wall x 5
17. Wall slides
With your hand and elbow resting on the wall try and slide it up the wall
Start with 5 repetitions then gradually
Then do the same facing sideways to the wall.
18. Half arm raise
With your hand on your shoulder -Lift the elbow up forwards
Repeat x 10
19. Half arm Abduction
Stand with your hand on your shoulder. Now lift the elbow up and back down. With half the weight of the arm this is much easier to do than with the arm straight
Repeat x 10
Week 3
Theraband exercises
Resisted external rotation
Standing or sitting keep your elbow tucked in to your side and pull elastic outwards. Do a slow controlled movement gently
Repeat x 5 and build up to 20
See Theraband exercises
Week 4
Other exercises
– Stand and push one hand into the palm of the other. Repeat 5 times and gradually increase to 20 repetitions.
– When you can do this easily you can use the Theraband and with elbow bent pull your hand in towards your stomach. Tie the Theraband on to a door knob or something similar.
Watch the knots to be sure that the Theraband does not suddenly give way
See Theraband exercises Internal rotation
Shoulder flexion in standing
Clasp your hands together and raise both of them above your head.
Then lower them separately out sideways with the elbows bent.
Repeat x 5
When easy do it both ways so go out to the side first and then down forwards
Shoulder stretch
Lie down on the bed. Put both hands behind your neck. Then try and let your elbows move apart downwards towards the bed. Repeat x 5
Pressups against the wall
This is a good strengthening exercise. You can make it harder the further away you stand from the wall.
Hydrotherapy
Water based exercises are a great option after shoulder surgery.
See all shoulder exercises that you can perform in water in the following link.
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