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This procedure typically involves an arthroscopic release of the restricted capsule followed by precise stretching to restore range of movement.
General points
- • Most improvement in the range of movement will typically occur within 3 months of surgery. Improvement is likely to continue for 18-24 months.
- • The aim of rehabilitation is good quality movement, and maximal function.
- • Do not sacrifice quality of movement and function for range of movement.
Immobilisation
- • Patient is provided with a sling in the immediate post operative period as a nerve block will typically have been used.
- • The sling should be discarded as soon as possible.
From 0-6 weeks:
Postural control and scapulo-thoracic setting.
Pendular exercises.
Active assisted external rotation.
Active assisted elevation in supine as comfort allows
Increase range of movement as soon as tolerated through passive and active assisted movement.
Active assisted exercises progressing to active exercises – utilise short lever, supine and closed kinetic chain exercises if appropriate.
From 6 weeks:
Progress to open chain long lever – remembering function.
Isometric exercises in variable starting positions progressing to resisted through range strengthening.
Continue to progress through graduated strengthening while maintaining range and quality of movement.
Functional Milestones
Driving: See general principles of rehabilitation
Swimming: 6-8 weeks
Golf: 8-10 weeks
Light work/gardening: 6-8 weeks
Heavy manual work/gardening: 10-12 weeks