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Rehabilitation protocol after shoulder arthroscopy

Article written by: ANDREI BOGDAN, MD, Orthopedics-traumatology doctor

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
Exercises
  • 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)
Exercises
  • 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).
Objectives
  • 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.
Exercises
  • The progression of strengthening training also includes weight exercises, Theraband exercises, and machine exercises.
Objectives
  • Full range of motion (both passive and active).

Week 6 - 8

Manual
  • Continue to mobilize soft tissues and joints.
Exercises
  • 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.
NB: All progressions are approximations and should only be used as guidance. Progression will be based on the individual condition of the patient, which is assessed throughout the treatment process.
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