Shoulder and Elbow Surgeon

 

Anterior Gleno-Humeral Joint Stabilisation Rehabilitation Protocol
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Stabilisation surgery can be open or arthroscopic (key hole) and involve repair of the soft tissues and bony damage to the gleno-humeral joint. The principles of rehabilitation are similar. If there is any doubt please consult Mr. Packham.

Aims:
The aims of rehabilitation are to protect the repair in the early stages and to maximally optimise function in the long-term.

General Points :
Do not push through pain.
Do not sacrifice quality of movement for range of movement.
Do not push into Abduction External Rotation (hand behind head, throwing or push up position) for at least 12 weeks post surgery.

Immobilisation:
The patient is to wear a sling day and night for 3 weeks (apart from to undertake exercises).
The patient is to wear the sling at night for a further 3 weeks, making a total of 6 weeks in total at night.

Post Operative Instructions:

0-3 weeks:
Care should be taken while dressing or if in doubt the sling should be worn under clothing.
Hand, Wrist and Elbow exercises.
Pendular exercises.

Encourage optimal Scapulo-Thoracic position.
Keep hand in the plain of the abdomen / stomach.

From 3-6 weeks:
Wean out of sling during the day– light activities within field of view only.
Gentle active and passive movements.
Gradually increase External Rotation
to neutral (handshake position)
Proprioceptive exercises.

No long lever open chain exercises until 12 weeks


From 12 weeks onwards:

Isometric exercises in variable starting positions progressing to
Resisted movements through range and strengthening


Functional Milestones and Activity Time Scales:


Driving
See general principles of rehabilitation.
Swimming 12 weeks plus.
Golf 12 weeks plus.
Contact sports 5 to 6 months.


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