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Shoulder Exercises – Rooms

Shoulder Exercises – Rooms

Exercises

255A Beyers Naudé Dr,
Rustenburg, 0299
Tel: +27 (0)14 592 8322
www.physiotherapy.co.za
P.O.Box 21533
Protea Park
0305
Hospitale/Hospitals
Netcare Ferncrest/Life
Peglerae/Medicare
Tel: +27 (0)14 592 8322

Shoulder Rehabilitation after Rotator Cuff surgery

 

PROGRESSIVE EXERCISES

 

EXERCISES SHOULD NEVER BE EXCESSIVLY PAINFULL
REPEAT ALL EXERCISES APPROXAMITALY 10 TIMES

2 – 4 Weeks

N

1 - Passive flexion: (This excersice will improve the forward movement of the
shoulder).

a. Lie down comfortably on your back.
b. Fold both forearms across your chest, hold each elbow with the opposite hand.
c. Slowly lift both your arms away from the body opening up the armpits.
d. The healthy arm must do all the work, while the operated arm should just relax.

N

2 - Passive abduction: (This excersice will improve the outward movement of the shoulder).

a. Lie down comfortably on your back.
b. Keep your arm as straight as possible.
c. Walk/Crawl outwards with your hand to open up your armpit.

N

3 - Passive external rotation: (This excersice will improve the rotation of the shoulder).

a. Lie down comfortably on your back.
b. Bend your elbow 90°.
c. Allow gravity to just let the arm fall away from the body.
d. When this is comfortable:
          1. Hold a stick in both hands.
          2. Use the stick to gently push the hand further.

N

4 - Hot pack for pain and muscle spasm.

a. Put a hotpack on the affected muscles for up to 20 min.
b. Do not over heat the hotpack.
c. Be carefull not to burn.

4 – 6 Weeks
THESE EXERCISES WILL PROGRESS YOUR PREVIOUS EXERCISES
N

1 - Active assisted flexion:

a. Wall crawls.
          1. Stand infront of a wall.
          2. Place both hands on the wall.
          3. Use your fingers to crawl as high as possible up the wall.
          4. When you cannot crawl higher:
                    a. Try to put your elbows against the wall.
                    b.Try to touch the wall with your forehead
          5. Guide your arm down with your healthy hand.
b. Pulley 1.
          1. Use a small pulley and rope attatched above your head. If you do not have this improvise using a towel/rope/tie over a                                          rail/beam/branch.
          2. Use your healthy hand to pull the operated arm up as high as possible in front of you.
          3. Repeat this up and down movement.

N

2 - Active assisted abduction:

a. Table top/Window sill:
          1. Stand an arms length away from a table or window sill facing sideways.
          2. Rest your hand on the table.
          3. Slowly bend your knees in order to open up the armpit as far as possible.
          4. Slowly stand up.
b. Pulley 2.
          1. Use a small pulley and rope attatched above your head. If you do not have this improvise using a towel/rope/tie over a
              rail/beam/branch.
          2. Use your healthy hand to pull the operated arm up as high as possible away from your side.
          3. Repeat this up and down movement.

N

3 - Active assisted external rotation against wall:

a. Stand close to a wall. Face away from the wall.
b. Push your operated sides shoulder blade, buttock and elbow flat against the wall.
c. Bend your elbow 90°.
d. Use a stick to gently push your hand towards the wall.

N

4 - Hand behind back (HBB):

Always progress in the following order and only advance to the next exercise if possible without severe pain.

a. First touch your buttock on the same side as your operated arm.
b. Then touch the opposite buttock.
c. Then try to move your hand up to the small of your back
d. Then try to move your hand up inbetween your shoulder blades.
e. Now hold a towel behind your back and pull the hand up higher.

N

5 - Scapula retraction: (Pulling back shoulder blades)

a. Lie on your stomach.
b. Keep your arms at your sides.
c. Lift your shoulder blades up towards the ceiling and down to the buttocks.
d. Hold this position for 10 seconds.

6+ Weeks

N

1 - Light stretches: Progress weekly.

a. Hold the position for 30 secs.
b. Repeat 3 times.

N

2 - Active movement.

a. Flexion
          1. Short arm/chicken wing: bend your elbow and move your arm forward.
          2. Straight arm: keeping your arm straight move your arm forward.
b. Abduction
          1. Short arm/chicken wing: bend your elbow and move your arm outward.
          2. Straight arm: keeping your arm straight move your arm outward.

N

3 - Hand behind head.

a. Put your hand behind your head as if you are washing/brushing your hair.
b. Move your hand further down towards your neck.

N

4 - Scapula retraction: (Pulling back shoulder blades).

e. Lie on your stomach.
f. Keep your arms at your sides.
g. Lift your shoulder blades up towards the ceiling and down to the buttocks.
h. Lift your hand upwards toward the ceiling.
i. Hold this position for 10 seconds.

N

5 - Theraband exercises: NB both sides!

a. Flexion
          1. Tie the theraband to a door handle. Close the door.
          2. Face away from the door.
          3. Hold on to the other end.
          4. Slowly move your arm forwards to roughly 45°.
b. Extension
          1. Face the door.
          2. Hold on to the other end.
          3. Slowly move your arm backwards to roughly 45°.
c. Abduction
          1. Turn so that the healthy shoulder is closest to the door.
          2. Hold on to the other end.
          3. Slowly move your arm outwards to roughly 45°.
d. Adduction
          1. Turn so that the operated shoulder is closest to the door.
          2. Hold on to the other end.
          3. Slowly move your arm inwards to roughly 45°.
e. External rotation.
          1. Turn so that the healthy shoulder is closest to the door.
          2. Hold on to the other end.
          3. Bend your elbow 90°.
          4. Slowly turn your arm outwards as far as possible without your elbow leaving your side. (If you struggle with this keep a small towel                    between the elbow and your body.)
f. Internal rotation
          1. Turn so that the operated shoulder is closest to the door.
          2. Hold on to the other end.
          3. Bend your elbow 90°.
          4. Slowly turn your arm flat against your body without your elbow leaving your side. (If you struggle with this keep a small towel                              between the elbow and your body.)
g. Scapula setting
           1. Hold the theraband behind your back.
           2. Keep your hands close together.
           3. Gently pull on the theraband apart while taking your hands slightly down and backwards.

Download Exercises - ROTATORCUFF REPAIR for Rooms.pdf

(Download the complete hospital exercise guidelines document)

Shoulder Exercises – Rooms

Shoulder Exercises – Hospitals

Exercises

255A Beyers Naudé Dr,
Rustenburg, 0299
Tel: +27 (0)14 592 8322
www.physiotherapy.co.za
P.O.Box 21533
Protea Park
0305
Hospitale/Hospitals
Netcare Ferncrest/Life
Peglerae/Medicare
Tel: +27 (0)14 592 8322

Shoulder Rehabilitation after Rotator Cuff surgery

 

GENERAL INFORMATION AND ADVICE:

 

N

Number 1

The sling must be worn for 4-6 weeks (depending on doctor’s orders) in order for the tissue to heal properly. (See exercises for how to wear the sling).

N

Number 2

Do not lift your elbow away from the body using you operated shoulder’s muscles. This will put too much tension on the affected area and could result in the operated tissue tearing.

N

Number 3

Physiotherapy is very important 2 – 3 x per week (depending on each patient’s progress). The physio must ensure that the shoulder retains good movement and does not become stiff. The aim is to have as much movement as possibe when the sling comes off. This is a delicate process and must be monitored constantly in order not to damage the surgery. The physio will also adress neck stiffness, muscle spasms, pain and swelling.

N

Number 4

Only after the sling has been removed and the doctor/physio is happy that the healing is sufficient, may the patient start doing gentle strenghtening exercises.

N

Number 5

Keep the wound dry while the wound is dressed. Plasters can usually be removed after 14 days or as the doctor ordered. If your wounds are red,warm or have a yellow discharge contact the doctors rooms. Carefully wash under the armpit with a cloth without lifting your elbow away from your body.

N

Number 6

Button down shirts are easiest to wear. When dressing, your operated shoulder should be into the sleeve first. When undressing your operated shoulder should be undressed last.

N

Number 7

Do not sleep without the sling. Do not sleep on the operated shoulder. Use a pillow to support the operated shoulder and arm when sleeping on the healthy side.

N

Number 8

Do not lift or grab anything while the arm is in the sling. No sudden movements with the arm.

N

Number 9

No driving while your arm is still in the sling. Only start driving when you can safely drive without any pain and your shoulder is strong enough to perform all the necessary actions.

N

Number 10

Maintain good posture (See exercises for examples of good posture).

N

Number 11

For swelling and pain ice and heat can be used (See exercises for time specific management).

N

Number 12

Do not do any gym exercises before 12 weeks post surgery. Consult your physio for a biokineticist referral
if you want to start doing gym exercises. The following exercises must preferably not be done in the gym
again:

a) Upward rows
b) Military Presses
c) Front/lateral fly’s
d) Dips

N

Number 13

Do not lift any heavy objects or play sport before a biokineticist is satisfied that you have reached the final stages of your gym-rehab.

EXERCISES:

0-2 Weeks
EXERCISES SHOULD NEVER BE EXCESSIVLY PAINFULL
REPEAT ALL EXERCISES APPROXAMITALY 10 TIMES

 

'

1 - Breathing Exercises

a. Sit or lie down comforatably.
b. Breath in through your nose.
c. Breath out through your mouth.
d. Keep your shoulders relaxed.
          1. Take a deep breath in and out.
          2. Take a deep breath in, hold for 3-5 sec and breathe out.
          3. Take a deep breath in, then a bit more in, and breathe out.

'

2 - Pendulem exercises:

a. Keep your back straight.
b. Use your body movement to get your arm swinging passively.
          1. Straight forward and backwards.
          2. Straight sideways from left to right.
          3. In small circles clockwise and anti-clockwise.

'

3 - Shoulder protraction/retraction:

a. Lie down on your back.
b. Lift your shoulders off the bed (forward).
c. Relax your shoulders and push your shoulder blades flat against the bed (backwards).
d. When you are comforatable with this exercise you can also do it while sitting.

'

4 - Elevation/ depression:

a. Lie down on your back.
b. Lift your shoulders up towards your ears.
c. Relax your shoulders and push then down towards your feet.
d. When you are comforatable with this exercise you can also do it while sitting

'

5 - Posture correction:

a. Sit on a hard chair.
b. Keep your back straight.
c. Pull in your stomach.
d. Tuck your chin backwards (ie make a dubble chin).
e. Pull your shoulder blades slightly down and backwards.
f. Now hold this position for 10 seconds.

'

6 - Circulation exercises to prevent blood clotting:

a. Keep your arm close to your body.
b. Carefully remove your forearm from the sling.
c. Use your healthy hand to stabilise your operated upper arm.
d. Gently do the following movements.
          1. Straighten and bend the elbow.
          2. Turn your hand up toward the roof and down toward the floor.
          3. Move your wrist in circles.
          4. Exercise your fingers.

'

7 - Ice for swelling and pain:

a. Cover the surgerical site with a clean sheet of plastic or a towel in order the protect the wounds and dressings.
b. Put an ice pack over your swollen or painful areas.
c. Keep it on for 10-15 minutes.
d. You can do this 3 times per day.

'

8 - Put the sling on correctly:

a. The strap around your neck should not be too tight.
b. The strap around your body should be nice and tight.
c. Your arm should be against your body.
d. Your elbow should be bend to 90°.
e. Your wrist should be well supported.

Download Exercises - ROTATORCUFF REPAIR for Hospitals.pdf

(Download the complete hospital exercise guidelines document)

Important!

All shoulder surgery patients require physiotherapy after dicharge from the hospital, to prevent post-operative complications and failure of surgery.

  • You will need 2-3 sessions/ week. Please phone the practice for an appointment ASAP.