It’s important to take surgery recovery seriously in order to ensure the long-term success of the procedure. In this article, we are going to discuss the recovery timeline after total shoulder replacement surgery.
0-6 weeks
- Immediately start Pendulums, Supine Active Assisted Forward Elevation (SAAFE), and External Rotation With Stick. It is imperative that the patient understands the exercises and are able to demonstrate that they can perform the exercises, as they are responsible for performing these at home. Stretching exercises should be performed 2 times per day.
- At FOUR weeks start internal rotation in the supine position. In the supine position, position the arm in about 300 of abduction. External and internal rotation can be performed in this position.
- All ranges of motion should be taken to tolerance and focus on long slow stretches with appreciable gains being realized each week.
6-8 weeks
- Start External Rotation Stretching in Doorway, Pulley assisted ROM,
- Start IR, ER and abduction isometric strengthening exercises. Start very slowly on the IR isometrics.
- Start Supine Active Forward Elevation (SAFE) exercises.
- Start Functional Internal Rotation using a towel or belt to pull the operative arm up behind the back.
- DC sling at 6 weeks
8-12 weeks
- It is important to work on scapular motion so that the acromion can be moved out of the way to achieve greater degrees of range of motion.
- Make sure that the patient is not developing substitution patterns with active range of motion. If the patient is developing these patterns then try Wedge Assisted Active Forward Elevation (WAFE). WAFE and stretching exercises should be performed on a daily basis and strengthening only every other day at most.
12-16 weeks
- Teach continued home program for deltoid Active Range of Motion and RC strength maintenance
- Other strengthening exercises can be started such as bench press and lat pulls and military press with dumbbells or with machines as long as form is good. There should be no pain with strengthening. When bench pressing, do not let the elbows extend below the plane of the body.
- Work on neuromuscular control
- Teach specific exercises and proper mechanics for a specific sport such as golf, racket sports, fishing, or a vocation. Throwing exercises such as concentric and eccentric resisted throwing with bands and throwers ten exercises can be started now.
16 Weeks
- Return to unrestricted activity. Impress upon the patient that heavy lifting and other weight bearing activities can lead to loosening and accelerated polyethylene/ glenoid wear and thus should be avoided.
