Rehabilitation protocol after shoulder arthroscopy
General considerations
- Using a sling for 1-2 weeks postoperatively
- Maintaining a correct posture when performing all exercises.
- Aerobic conditioning during the rehabilitation process.
- Postoperative medical examinations: Day 1, 4 weeks, 3 months, 6 months, and 1 year.
- All active exercises should be closely monitored to minimize substitution or compensation.
Week 1
Manual- Soft tissue mobilization, massage to reduce edema
- Mobilization exercises in all planes, in the limit of pain
- Flexion and extension of the elbow, strengthening the wrist and forearm joint.
- SCervical stretching, scapular girdle mobilization.
- It is very important to remove the slings frequently to bend and straighten the elbow for 10-15 repetitions each time to reduce the swelling of the operated arm.
- Cardiovascular physical exercises (medical bicycle, elliptical bicycle, Stairmaster).
- Objectives
- Reduction of edema and pain.
- Passive range of motion, adduction up to 90 degrees, external rotation up to 30 degrees.
Week 2 - 4
Manual- Continue the treatment of the soft tissues, the passive scope of the movements, the mobilization of the scapula, light mobilizations of the joints in the limit of the pain.
- Pain control (cryotherapy, massage, electrical stimulation)
- Isometric exercises - all planes.
- Initiate active movements in all planes within the pain tolerance limit.
- Scapular girdle strengthening exercises with Theraband.
- General tolerable conditioning (includes flexion and torso extension exercises).
- Reduction of pain and edema.
- Passive range of motion, adduction up to 120 degrees, external rotation up to 60 degrees.
- Active range of motion, 90-degree adduction, and abduction with good mechanics.
Week 4 - 6:
Manual- Continue to mobilize soft tissues and joints.
- The progression of strengthening training also includes weight exercises, Theraband exercises, and machine exercises.
- Full range of motion (both passive and active).
Week 6 - 8
Manual- Continue to mobilize soft tissues and joints.
- Continue strengthening the rotator cuff in all planes of motion.
- Initiate light throwing activities.
Week 8+
- Initiate specific sports training as long as it is tolerated without pain.
- Continue strengthening, endurance exercises, and general fitness.
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