Sling | When will I go home? | What can I do? | What can’t I do? |
4 weeks | You will be discharged on the same day as the operation | Range of movement within safe zone* | No combined abduction/external rotation, no end range ER, no lifting |
Acute phase (0-4 weeks)
Goals
- Protect the surgical repair
- Reduce pain
- Promote cuff and scapular control
Rehabilitation
- *Safe zone: aim for passive range of movement to 120° elevation, 45° abduction, 30° external rotation by end of second week
- Active assisted/supported range from 2 weeks
- No eccentric or concentric loading of biceps
- No forced movements, no combined abduction/external rotation
- Closed kinetic chain/proprioception exercises
- Cuff exercises within this range of movement zone
- Scapular setting exercises
- Elbow, wrist, hand exercises
Criteria for progression
- Pain control
- Adequate range of movement
Intermediate phase (4-8 weeks)
Goals
- Preserve surgical repair
- Restoration of functional range of movement
- Cuff recruitment and scapula control through range
- Enhance proprioception
Rehabilitation
- No passive stretching into end range external rotation
- No eccentric biceps loading
- No heavy lifting/concentric overload biceps
- Encourage active movement with good cuff and scapular control
- Progress cuff & scapular recruitment through range
- Progress kinetic chain integration
- Proprioceptive re-education incorporating closed chain exercises
- 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 cuff and scapular control under load
- Enhance shoulder power, strength and endurance
- Ensure cuff and scapula control maintained during biceps loading
Rehabilitation
- Regain optimal range of movement into combined positions
- Ensure posterior capsule mobility
- Specific biceps strengthening/control work ensuring maintenance of scapula control and humeral head position
- Strengthening and endurance exercises for cuff and scapular musculature
- Preparatory and reactive stabilisation drills in risk positions
Guidelines for return to functional activities
Driving |
Lifting |
Swimming |
Golf |
6-8 weeks | Light lifting 4 weeks. Avoid heavy for 3 months | Breaststroke 6 weeks, freestyle 12 weeks | 3 months |