SLING DURATION |
WHEN DO |
WHEN CAN |
4 Weeks. |
You will begin physiotherapy two weeks after your operation. |
In approx 4-6 weeks, when you’re no longer using the sling and have full control of the vehicle. |
Acute phase (0-4 weeks)
Goals
- Reduce pain
- Respect surgical repair
- Begin controlled range of movement
Rehabilitation
- *Safe zone: passive forward flexion to maximum 90°, passive external rotation to neutral
- Teach scapular setting, postural correction
- Pendular exercises
- From 2 weeks, commence assisted active forward flexion to 60° (eg with cane, stick)
- Elbow, wrist and hand exercises
- No active forward elevation or abduction exercises
Criteria for progression
- Pain control
Intermediate phase (4-8 weeks)
Goals
- Discard sling
- Restore functional range of movement
- Re-educate cuff recruitment and scapular control through range
- Enhance proprioception
- Preserve surgical repair integrity
Rehabilitation
- Progress range of movement beginning with passive movement, and then increasing active assisted and active as tolerated, whilst respecting pain
- Commence cuff strengthening regime
- Ensure dynamic scapular control through range
- Hydrotherapy permitted
Criteria for progression
- Pain free range of movement
- Scapular and cuff musculature control through range
Late phase (>8 weeks)
Goals
- Restore full range of movement
- Optimise cuff and scapular control under load
- Enhance shoulder power, strength and endurance
Rehabilitation
- Continue to increase range of movement to functional range
- Strengthening and endurance exercises for cuff and scapular musculature
Guidelines for return to functional activities
LIFTING |
SWIMMING |
GOLF |
Light lifting at 6 weeks, avoid heavy lifting for 3 months. |
Breaststroke 6 weeks, freestyle 12 weeks. |
3 months. |