In this article, we are going to discuss the goals for recovery following a capsular release for frozen shoulder.
Goals & Guidelines:
Remove sling after the first postoperative day. Patients may use arm for all ADL’s. The goal of the postop rehabilitation is to maintain this ROM gained in the operating room with long slow stretches in all planes to prevent recurrence. It should be emphasized to the patient that these stretches should be performed 2-3 times daily at home. Each session should last 20 minutes. Instruct the patient on the use of heat and analgesics 30 minutes prior to stretching. Emphasize holding each stretch for at least 10 seconds. The most important time is the first 6 weeks. If the patient does not get FROM in the first 6 weeks, then it will be very difficult to obtain it thereafter. Periscapular and postural strengthening exercises may be initiated once FROM is attained. Make sure to pay close attention to diabetic patients, as they will tend to have higher recurrence rates and thus need to be especially diligent with the stretching.
0-2 weeks
- Begin passive supine FE-ER to full, AROM in all planes, ER with stick, IR behind the back and Cross body adduction
- Encourage AAROM with HOME PULLEY
- D/C sling postoperative day 1
2-6 weeks
- Begin Alternate Internal Rotation Stretch, Overhead Pulley, Sleeper stretch, Wall slide into Scaption, ER at the doorway, Hand across chest
6-12 weeks
- Start 4 way shoulder resistive band strengthening and periscapular strengthening exercises working on proper joint kinematics.
