Shoulder Rehabilitation

Reverse Shoulder Protocol

SlingWhen will I go home?What can I do?What can’t I do?
4 weeksYou will be discharged on the day after the operationRange of movement within safe zone*No weight bearing through arm, no forced movements. No lifting

Acute phase (0-4 weeks)

Goals

  • Pain control
  • Protect the shoulder replacement
  • Re-educate optimal deltoid function

Rehabilitation

  • *Safe zone: commence passive range of movement to maximum 90° elevation, 30° external rotation
  • Progress to active assisted and support range of movement within this safe zone
  • No combined external rotation/abduction
  • No extension
  • No hand behind back
  • External rotation control exercises
  • Scapular setting exercises
  • Optimise deltoid function
  • Criteria for progression
  • Pain controlled
  • Deltoid function

Intermediate phase (4-12 weeks)

Goals

  • Restoration of active range of movement
  • Continue to optimise deltoid function
  • Optimise dynamic control through range

Rehabilitation

  • Progress range of movement
  • Progress cuff compensation program (ie. deltoid)
  • Progress rotational exercises
  • Scapular control through range
  • Scapular dissociation/mobility exercises
  • Functional extension and hand behind back exercises
  • Hydrotherapy permitted

Criteria for progression

  • Pain controlled functional range of movement
  • Quality of movement pattern
  • Deltoid function through range
  • Active external rotation control

Late phase (>12 weeks)

Goals

  • Rehabilitate functional specific strength and endurance
  • Aid functional independence

Rehabilitation

  • Function specific strength and endurance
  • Loaded exercises (eccentric & concentric)
  • Internal and external rotation resistance exercises
  • Functional movement pattern re-education
  • Institute home exercise program (for maximum improvement may take up to 2 years to achieve)

Guidelines for return to functional activities

DrivingLiftingSwimmingGolf
6 weeksLight lifting 6 weeks, avoid heavy until 6 monthsBreaststroke 8 weeks, freestyle 12 weeks4 months
Devinder Garewal
SHOULDER SPECIALIST

Mr. Devinder Garewal

MBBS, BMedSci, FRACS (Orth), FAOrthA

Mr. Devinder Garewal is an orthopaedic shoulder specialist. Devinder completed his medical qualifications from the University of Melbourne and is a Fellow of the Royal Australasian College of Surgeons and the Australian Orthopaedic Association.

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Shoulder Joint

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Elbow Joint

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