SHOULDER ARTHROSCOPY

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

• 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

• 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:

• 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

• 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.