Common types of shoulder surgeries that may require physical therapy include:
Rotator cuff repair Labrum repair Proximal humeral fracture reduction Clavicle fracture reduction Biceps tendon repair Subacromial decompression
Each of these surgeries carries with it specific treatments and techniques to safely achieve the best outcome. Some variables of a physical therapy program remain the same throughout; the basic goals during rehab after shoulder surgery are to safely improve range of motion (ROM), strength, and overall functional use of your arm. Your physical therapist can help you achieve those goals.
Here is a list of some of the things that you may work on with your physical therapist after shoulder surgery. The list starts with simple passive motions and progresses in difficulty and stress as you progress through your shoulder rehab. This list does not replace the advice of your healthcare provider or physical therapist. You must check with your practitioner before starting these, or any other exercises after shoulder surgery.
While wearing your sling, you may find that the muscles of your forearm and wrist or hand feel like they are getting weak. Your physical therapist may have you perform some putty squeeze exercises to keep your hand and forearm muscles working properly as your shoulder heals.
You may use a pulley system in the PT clinic to help improve your shoulder ROM through flexion, abduction, and internal rotation. Using a pulley system at home may be necessary. Your PT may be able to lend you a shoulder pulley, or you can make one yourself with some simple hardware store items.
Even if you are still wearing your sling, you can perform shoulder isometrics to start engaging your rotator cuff muscles. This can help prepare your shoulder muscles for increased workloads in the coming weeks of rehabilitation for your shoulder.
Don’t be concerned if you initially find moving your arm difficult; your shoulder has been in a sling and has recently undergone the trauma of surgery. Your rotator cuff and deltoid muscles have not been called into action recently, so they may not be able to fully raise your arm. As you practice the active ROM exercises, you should find that your shoulder and arm function normally in a few short days.
When you have pain or weakness in your shoulder after surgery, the muscles around your scapula may not function properly. This causes improper shoulder and scapular motion that must be corrected.
To overcome scapular muscle dysfunction, your physical therapist may have you begin scapular stabilization exercises. These exercises are essential to help you regain normal mobility in your shoulder complex.
You can also use a small dumbbell to add resistance to your active range of motion exercises. After surgery, it is important to start light and slowly increase the sets and repetitions of each exercise before adding additional weight to the exercise. Your physical therapist will help you progress through your shoulder and rotator cuff strengthening program.
The Thrower’s 10 exercises are a group of exercises designed to improve the strength and mobility of your entire arm so you can prepare for more advanced overhead activities.
When returning to throwing activities, start out easy. Start with a gentle soft toss, and progress your throwing gradually over a period of weeks. No need to get out there and start gunning it; start with simple throws over a short distance and gradually increase the number of throws your do and the distance between you and your throwing partner. Do not progress to advanced overhead throwing and strengthening activities until your healthcare provider or physical therapist advises you to do so.
If you are an athlete or if you work in a job where you may have to quickly catch or throw something, then you may benefit from performing shoulder plyometric exercises.
Specific exercises like using the Bodyblade or using small weighted therapy balls can train your shoulders and arms to respond quickly whenever you need to catch or throw something.
