Prof. Lennard Funk’s Education Portal

Call: 01625 545071
Email: [email protected]
For treatment enquires visit The Arm Clinic

Shoulder Replacement

Indications:

  • Severe osteo or rheumatoid arthritis where the predominant feature is pain

 Protocol

  In Patient
Day 0

Day 1

Level 1 Exercises

  • Body belt removed
  • Axillary hygiene taught
  • Pendular exercises
  • Scapular setting
  • Passive flexion in the scapula plane as comfortable 
  • External rotation to neutral
  • Discharge usually at day 1
  Out Patient
Day 5-

3 weeks

Level 2 exercises

  • No resisted internal rotation or forced passive external rotation (reattached subscapularis muscle is vulnerable)
  • Begin passive abduction (maintain shoulder in IR)
  • Passive external rotation to neutral only
  • Active assisted flexion in supine and progress to sitting position as soon as the patient is able.
  • Progress to active when possible
  • Begin isometric strengthening of all muscle groups (except IR)
  • Remove sling as able
  • Functional reaching activities below 90 degrees

3 weeks +

Level 2 exercises

  • Encourage active movement into all ranges with some gentle self-stretching at the end of range.
  • Add isometric IR
  • Progress functional activities

6 Weeks +

Progress to levels 3 exercises

  • Progress strengthening through range
  • Regularly stretch the joint to the end of its available range
  • Soft tissue manipulation if required

 

Milestones

 

Week 350% of pre-op active ROM

Week 6

Passive ROM to at least pre-op level

Week 12

Active ROM to at least pre-op level


See Post-Operative Exercises
          

 Improvement continues for 18 months to 2 years and the patients should continue exercising until their maximum potential has been reached

Return to functional activities

Driving                        After 4 weeks

Swimming                   Breaststroke:   6 weeks

                                    Freestyle:         12 weeks

Golf                             3 Months

Lifting                         Light lifting can begin at 3 weeks. 
                                   Avoid lifting heavy items for 6 months.

Return to work            Sedentary job: 6 weeks
                                    Manual job:      Guided by Surgeon

For more information please contact us


Related Links:
1. Rehabilitation for Surface Replacement - Diana Middleton

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