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 |
Acute phase (0-4 weeks)
Goals
- Reduce surgical repair
- Reduce pain
- Commence controlled shoulder range of movement Promote improved proprioceptive acuity
Rehabilitation
- *Safe zone: aim for passive range of movement to 90° elevation, 45° abduction, 0° external rotation by end of second week
- Active assisted/supported range from 2 weeks
- No forced movements, no combined abduction/external rotation
- Closed kinetic chain/proprioception exercises (ie. with ball)
- Cuff exercises within this range of movement zone
- Scapular setting exercises
- Elbow, wrist, hand exercises
Criteria for progression
- Controlled pain
- Adequate range of movement (need adequate rotational range of movement before introducing active through range cuff facilitation work above 90°)
- Compliance with exercises
Intermediate phase (4-8 weeks)
Goals
- Discard use of sling
- Restore functional range of movement
- Re-educate cuff recruitment and scapular control through range
- Enhance proprioception Preserve surgical repair integrity
Rehabilitation
- No passive stretching into combined abduction/external rotation
- Encourage active movement with good control and without apprehension
- Engage cuff & scapular stabilisation
- Progress cuff & scapular recruitment through range
- Progress kinetic chain integration
- Closed kinetic change work
- Hydrotherapy permitted
Criteria for progression
- Painfree functional range of movement
- Good cuff and scapular control through functional range
Late phase (>8 weeks)
Goals
- Restore full range of movement
- Optimise preparatory and reactive stabilisation
- Optimise cuff and scapular control under load
- Enhance shoulder power, strength and endurance
Rehabilitation
- Regain optimal range of movement into combined positions
- Enhance neuromuscular control through range and incorporated with kinetic chain
- Ensure high level strengthening and endurance exercises for cuff/scapular musculature through range, particularly risk positions
- Preparatory and reactive stabilisation drills in risk positions
Guidelines for return to functional activities
LIFTING |
SWIMMING |
GOLF |
Light lifting at 4 weeks, avoid heavy lifting for 3 months. |
Breaststroke 6 weeks, freestyle 12 weeks. |
3 – 6 months. |