Shoulder Surgery Rehab: Exercises for the First Six Weeks | Martin Kelley, DPT of Penn Rehab

- You just had

shoulder

surgery

and now you are eager to return to the activities you did before

surgery

. I'm Marty Kelly from Penn Rehab and I'm going to show you

exercises

that you will do during the

first

phase of

rehab

. The

first

exercise I'm going to show you can be done in a lying or standing position or sitting in the sling. But we're going to go ahead and get Bryson out of the sling to prepare him for other

exercises

he'll do. His arm will be at rest. You're going to throw punches. Make a fist and hold it for 3 seconds.

Open it. And why do you do this? This is to help maintain strength in the forearm muscles, but more importantly you are trying to use these muscles as a pump to get fluid out of them. The problem is that when your arm is at your side for long periods of time, you tend to accumulate fluid in your forearm and hand. So this will help get that liquid out. Three seconds, squeeze, open, hold for 3 seconds and do it 10 to 20 times. You can do it 10 times a day. The next exercise will be with the arm more or less at the side, protected on the pillow.

Let me straighten my elbow, lower it, and then bend my elbow all the way up. So, being in a sling all day, you can straighten it back and your elbow can get stiff. That's why we want you to do some elbow exercises to make sure you maintain movement in your elbow. This can also help with fluid buildup, but just put your elbow in a straight position, hold it for a few seconds, bend your elbow completely, hold it for a few seconds, do that 10 to 15 times, 3 to 5 times up to date. . The next exercise is really important. This is to prevent excessive stiffness in the

shoulder

, but absolutely to protect the surgical area, whether you have had a rotator cuff repair, total shoulder arthroplasty, SLAP injury, or Bankart repair.

Almost all of them are performed in this position within a 30 degree range, and I'll talk more about those 30 degrees in a moment. What you are going to use to do this is some type of wand device. You can use a golf club, you can use an umbrella, you can use a broomstick. You can go to the hardware store and get some PVC pipe and put little T's on the end. The point is that you will place whatever you choose to use in your surgical side hand and then grab it with your other hand. I would recommend that the other arm rest on the pillow.

This hand, the non-surgical hand, will be towards the waist. Your surgical arm will be on a pillow about 6 to 8 inches from the side of your body, and the elbow will be at a right angle or at a 90-degree angle, so just in this position. When we begin the exercise, we consider this position as our zero position. This is where you will start from and use the other arm. Try to relax your surgical side and you are going to do it gently with the other arm, this surgical side is totally relaxed, you are going to push outward until you move 6 to 8 inches to the side or what is considered a 30-degree angle, and that will be seen in a particular view here.

You're going to hold that for about 10 seconds. You will return it to the starting position, which is approximately zero or where the forearm is vertical and you will repeat it 10 to 15 times. Again, that will depend on who is instructing you in those first few exercises. But normally, you will hold the position for 10 seconds and do it 10 times. The next exercise we are going to do is the forward raise and it is a passive exercise, meaning the other arm does all the work. So, I'm going to have Bryson grab his wrist on the surgical side and completely relax his surgical arm, which in this case is his left side, and use his right arm to bring his left arm over his head.

You're going to think about your hands going over your face and taking it as far as you can. Now, you are going to feel some discomfort when you do this exercise. So take it to the point where you feel some discomfort. You are going to hold it for 10 to 15 seconds. So we'd like to start with maybe 10 seconds and over time we'll increase that wait time to 15 seconds. Again, fully relaxing the surgical side, then use the other side to lower it back onto a folded pillow. It is very important that you start with a folded pillow. If you do not use the pillow, the arm will fall to the surface, which will create great discomfort and may actually cause some strain on the repair site.

So you would do this 10 times, hold for 10 to 15 seconds and do it 3 times a day. The next exercise is the pendulum. This is a good warm-up exercise that you can do standing up. You're going to be in the sling. You come out of the sling as we have seen before, simply by bending over. You will use your kitchen table to help you support yourself, one leg behind the other. The arm just hangs down and Bryson just goes to do some circles. So he's not actually using his shoulder muscles. He's just letting his arm swing very gently in circles, and you can swing it about 20 times, say clockwise or counterclockwise, and then after 20 you just go back, go in the direction opposite.

You would bend to the point where you feel comfortable. If this was uncomfortable, if you stood up a little, you could do the pendulum from there. If you could lean further, you would do it from that position. The next exercise that I am going to show you is what we call a chair stretch, and this is an alternative to the exercise that we just did lying down, the forward elevation stretch, because the one that is lying down can be quite uncomfortable in the early stages of the postoperative period. . This is actually an easier stretch and does the same thing: maintain the lifting motion forward.

Bryson will then go ahead and take his arm out of the sling. He will bow while he does that. He will take his other hand and place it on the chair. Now you could do this, and go ahead, lean on the table. So at home, you can do this at the kitchen table and place a chair in this orientation. Now you'll start to walk away, and as you walk away, let's stop right there, you'll lean forward. And that's probably how far you can go before you feel discomfort. Again, the idea is that you get to the point, you feel some discomfort.

You hold that position for 10 to 15 seconds and then go back up. Alright. Stand up to avoid back pain. Repeat the process, okay. If you can go back further, do so. I'm going to make you do it one more time. Then the hand is on the table to support the weight of the body. Put one leg behind you and then lean over. The weight moves away. You're not pushing this hand, it's okay. The weight moves away. Get to the point where you can get good elevation. The angle between your arm and your body increases. Ten, 15 seconds. Repeat that 10 times, doing it 3 times a day.

These exercises will guide you through the first six

weeks

of your

rehab

ilitation and are really essential for maintaining movement while protecting tissue. Once you're safely through these first six

weeks

, we'll move on to exercises including active assistance range of motion, active range of motion, and resistance exercise, and we'll show you that in the next video.