Shoulder Surgery Rehab: Exercises for 7-12 Weeks After Surgery| Martin Kelley, DPT of Penn Rehab


– Hi, and welcome to Phase 2 of your rehabilitation
following surgery. I’m Marty Kelly
with Penn Rehab and I’m going to
show you exercises that you would start six weeks
after your surgery. You want to do these exercises only after six weeks because they’re a little
bit more progressive. So if you’re not at six weeks, go back to your
Phase 1 exercises. The next exercise
I’m going to show you is called shoulder extension. This typically starts
six weeks postoperatively, but in some cases, it can start
somewhere up to 12 weeks postop. So just contact your physician
or he will tell you about that. The way we’re going to
do this exercise is you’re going to
hold onto your stick, cane, golf club,
whatever you’re using. Your hands are about
shoulder-width apart. The elbows
are relatively straight, the palms facing back. You’re going to
turn and face me. And now I’m going to
have you lift back. Your nonsurgical arm
will help the surgical arm. You’ll take it to the point
where you feel some stretch. Don’t force the motion. You’re going to hold that
for about 10 to 15 seconds. You’re going to do that
10 times. When you come out
of the position, you’ll rest for a few seconds and then move back
into it again. The next exercise
I’m going to show you is shoulder internal rotation. This exercise is done
six weeks postoperatively but sometimes you may not
start that up to 12 weeks. Talk to your physician
about that. So the way
we’re gonna do this is, we’re gonna have the hands kind of,
slide toward each other, but if you cannot get
your hands together then you want to try to separate
them to comfort, all right. So you separate them
to the point where you feel
a little bit of discomfort. If you can get your hands
to touch, perfect. From wherever your hands are
where you’re comfortable, you then want to slide
the hands up the back to the point where you feel
that increase in stretch. Again, don’t force this stretch. It’s just to the point
you feel an increase in pain. You’re going to hold that
for 10 to 15 seconds and then you’ll slide it
back down. Give it a few seconds’ break
and repeat the process. You’re going to do that
10 times, doing that 3 times a day. The next exercise
I’m going to show you is horizontal adduction
or cross-body stretch. This is typically done
six weeks postoperatively although
in some surgical procedures, it may not start
for 10 to 12 weeks. Talk to your physician
about that. To do the exercise, you’re going to reach across
with your nonsurgical arm, and you’re going to hold
behind your elbow. So you’re really trying to
relax the surgical arm. You can bring this
across the chest typically in a lower position
is better to begin because the higher you go, you’ll actually be compressing
the rotator cuff and/or the surgical area
of most surgeries performed. So start low on the chest. You’re going to pull
across and into you. You’ll stop at the point where you feel the beginning
of discomfort. You’re going to hold that
for 10 to 15 seconds. You’ll come out of the position
a few seconds. Give it a break and then repeat
that process again, holding 10 to 15 seconds. You’re going to
do that 10 times. Do that 3 times a day. Your therapist may talk
about doing this one a little bit more
through the day, maybe up to 5 times. We’re going to start exercises that are designed to lift
the weight of your arm. Now you’ve got to realize
that your arm has weight to it. You don’t need to put an extra
weight in it when you move. But the weight
of the extremity changes based upon
where you are to gravity. For instance, if I were to place Bryson’s arm in this position, it hardly weighs anything
relative to gravity, but if he were standing
and his arm were out in the same position, this is where his arm
weighs the most. So early on when we begin
rehabilitation, we’re going to just use
the weight of the extremity and change your body
relative to gravity. One of the initial exercises we’re going to use the other arm to help raise
his surgical arm. So we’re going to start
with the elbows bent. Now here’s another
little physics issue. If the elbow is bent
versus the elbow straight, the arm weighs less
with the elbow bent. So we’re going to start
with the elbow bent, a little less stress
on the surgical site, and I’m going to ask Bryson
using his nonsurgical arm and his surgical arm to lift
the stick/cane/golf club up to shoulder level
and then continue as far as he can
over the head and then hold that
for 10 to 15 seconds. He’s going to hold it there. He stops at the point
where there’s discomfort. It’s not going to really
create significant pain. Bring the arm back down,
elbows are bent, return to the initial
start position. So again,
this is activating muscles, still protecting
the surgical repair. These exercises are done
after six weeks. Let me have you do it again. Bring it on up. The right arm is assisting. Over time you can assist less
with your nonsurgical arm. In between reps,
you wait 3 to 5 seconds, give a little break. Now to progress this,
bring it on down. You would then start
with the elbow straight. The arm weighs more. Bring the arms up
and if you’ll notice, it will feel significantly different because there’s much more weight
to your arm, more tension
on the surgical repair site or the surgical site itself. And again, same thing,
10 to 15 seconds. Talk to your physical therapist
about when to progress from elbow bent
to elbow straight. Okay, you’re at a point now
where you no longer need assistance
of the nonsurgical arm. So I’m going to have Bryson
go ahead, bring the arm
in this position. Elbow is bent.
It weighs less. He’s going to go ahead and reach on up over the head
and continue on up. Gets that stretch. He’s going to hold that
for 10 to 15 seconds. After 10 to 15 seconds,
bring the arm down, bend the elbow. Again, I would
recommend doing it with a doubled-up pillow underneath your arm. When that becomes easy to do, then you straighten
the elbow out. The arm weighs more.
Bring the arm up. It’s like putting
a weight in your hand just by straightening
your elbow; 10- to 15-second stretch. Again, talk
to your physical therapist about when to progress from elbow bent to arm straight. You will repeat that 10 times,
doing that 3 times a day. This next exercise
is a table slide. This is again to activate
muscles of the shoulder but still have
some support of the extremity by the table. So go ahead and lean forward. As he leans forward,
he’s using his muscles to slide that arm forward. He’s going down
as far as he can. That’s increasing his
elevation range of motion. So again active-assistive
exercise. You’re going to hold that
10 seconds, bring it back on up,
doing that 10 times. This next exercise
is a ball roll exercise. It can be done sitting.
It can be done standing. We’re going to show
the sitting exercise. Now you may not have
a ball this big, but you can use
a basketball, soccer ball. You’re going to place
your hand on the ball and then you’re just
going to reach forward. The ball is supporting
the weight of the extremity but muscles are being used. So if you’re using
a soccer ball or a basketball, your arm may not go as high. Bring it on back. But you’re still getting
activity and support from the ball. Go ahead forward again. Now this one you don’t
need to hold this. This is just a movement
back and forth. I really want you to concentrate
on moving the arm and not shrugging the shoulder. Let me have you kind of
shrug the shoulders. We don’t want to do that.
Bring it back down. Relax. Do it again.
Kind of shrug as you do it. We’re trying to really
just get arm motion. Bring it on back down. So relax your shoulder,
reach forward, and back and forth just holding
for a couple seconds, doing that 10 to 20 times and you can do that
3 times a day. So we showed you
doing the exercise where you’re doing
a single-arm raise with the elbow bent
and straight and you can progress that and talk to your physical
therapist about this. If you begin to incline
yourself, so if you have a recliner, set that recliner back
so you’re inclined somewhat and then you repeat
the same exercise. Elbow is bent. You’re going to reach
over the head, but because you’re at an angle, your arm weighs more because now you’re becoming
more vertical, and that’s adding resistance. So you can use your recliner
to do that. You can use a beach chair
or a chair that you use outside if you’re in the summer months that will be angled up and you progress
that exercise based upon
how much you angle it. So the more vertical you are,
the straighter your arm is. Discuss that
with your therapist. You would raise the arm,
hold for 10 seconds, bring the arm back down. Start with the elbow bent and then progress
with the elbow straight. If you stick to
a consistent program and do these exercises properly, you’ll be ready to move on to
the final stages of your rehab. And really, most importantly
you’ll be ready to go back to doing those activities
that you did before surgery.

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