Shoulder Surgery Rehab: Exercises for the First Six Weeks | Martin Kelley, DPT of Penn Rehab

Shoulder Surgery Rehab: Exercises for the First Six Weeks | Martin Kelley, DPT of Penn Rehab


– You just had shoulder surgery and now you’re anxious
to get back to the activities that you did
before the surgery. I’m Marty Kelly
with Penn Rehab, and I’m going to show you
exercises that you’ll do during the first phase
of rehabilitation. The first exercise
I’m going to show you can be done
in a lying down position or it could be done standing
or sitting in the sling. But we’re going to go ahead and get Bryson
out of the sling here to get ready for some other
exercises he’s going to do. The arm is going to be rested. You’re going to do fist pumps. Make a fist,
hold 3 seconds. Open it up.
And why are you doing this? This is to help maintain strength in the forearm muscles but really, more importantly, you’re trying to use
these muscles as a pump to move fluid out of them. The issue is
whenever your arm is at the side for long periods of time, you tend to accumulate fluid
in the forearm and hand. So this will help
to move that fluid out. Three seconds, squeeze,
open up, hold for 3 seconds, doing that 10 to 20 times. You can do that 10 times a day. The next exercise
is going to be with the arm
kind of at the side, protected on the pillow. Let me have you
straighten the elbow and bring that on down and then bend the elbow
up all the way. So being in a sling
all day long, you can straighten that
back out, your elbow can get stiff. So we want you to do
some elbow exercises to make sure you maintain
motion at the elbow. This also can help with
fluid accumulation, but just working the elbow
into a straight position, holding for a few seconds, bending the elbow fully, holding for a few seconds,
doing that 10 to 15 times, doing that 3 to 5 times a day. The next exercise is really
an important exercise to do. This is to prevent excessive stiffness at the shoulder but absolutely to protect
the surgical area whether you’ve had
a rotator cuff repair done or total shoulder arthroplasty or a SLAP lesion
or a Bankart repair. All of them pretty much
are done in this position when within a 30-degree range, and I’ll talk more about
that 30 degrees in a little bit. What you’re going to use
to do this is some type of rod device. You can use a golf club,
you can use an umbrella, you can use a broomstick. You can go out
to the hardware store and get PVC pipe and put
little T’s on the end of it. The point is that you’re
going to place whatever you choose
to use into the hand on the surgical side, and then grab it
with the other hand. I would recommend
that the other arm is supported by the pillow. This hand,
the nonsurgical hand, is going to be down
towards the waist. Your surgical arm
is going to be up on a pillow about 6 to 8 inches
from the side of your body, and the elbow is going to be
at a right angle or a 90-degree angle,
so just in this position. When we start the exercise, consider this position
as being our zero position. This is where
you’re going to start from, and you’re going to use
the other arm. Try to relax your surgical side and you’re going to gently
with the other arm, this surgical side
is totally relaxed, you’re going to push out
until you move 6 to 8 inches out to the side or what is considered a 30-degree angle, and that will be seen
on one particular view here. You’re going to hold that
for about 10 seconds. You’re going to bring it back
in to the start position which is about zero or kind of
where the forearm is vertical and you will repeat that
10 to 15 times. Again,
that will be dependent upon who is instructing you
in those early exercises. But typically,
you’re going to hold for 10 seconds,
doing that 10 times. The next exercise we’re going
to do is forward elevation, and it’s a passive exercise meaning that your other arm
does all the work. So I’m going to have Bryson
grab his wrist on the surgical side, and he’s going to totally relax
his surgical arm which in this case
is the left side and use his right arm to bring his left arm
over the head. You’re going to think
about your hands passing over your face and bringing it up
to the point that you can. Now, you’re going to be–
have some discomfort when you do this exercise. So take it to the point
where you feel some discomfort. You’re going to hold
for 10 to 15 seconds. So we’d like to start
maybe at 10 seconds and over time we’ll increase
that hold time to 15 seconds. Again, totally relaxing
the surgical side, you then use the other side to bring it back down
onto a doubled-up pillow. It’s very important you start
from a doubled-up pillow. If you don’t use the pillow, the arm falls down
to the surface, and that will create
a great deal of discomfort and actually can cause
some tension on the repair site. So you’d be doing this 10 times,
holding 10 to 15 seconds and you’re going to be
doing this 3 times a day. The next exercise
is the pendulum. This is a nice warm-up exercise
that you would do standing. You’re going to be in the sling. You come out of the sling
like we’ve seen before, just leaning over. You’re going to use your kitchen
table to help support you, one leg behind the other. The arm is just dangling, and Bryson is just
going to make some circles. So he’s really not using
the muscles of the shoulder. He’s just kind of, very gently letting his arm swing
in circles, and you can swing that
about 20 times say clockwise or counterclockwise,
and then after 20, you just reverse,
go the opposite direction. You would lean over to the point
where you feel comfortable. If this were uncomfortable,
if you stood up a little bit, you might do the pendulum
from there. If you could lean over more, then you would do it
from that position. The next exercise
I’m going to show you is what we call chair stretch, and this is an alternative to the exercise
we just did lying down, the forward elevation stretch
because the one lying down can be quite uncomfortable in
the early postoperative phases. This is actually
an easier stretch and it does the same thing which is to maintain
forward elevation motion. So Bryson is going to go ahead
and kind of slip his arm out of the sling. He’s going to lean over
as he does that. He’s going to take
his other hand and place that hand
on the chair. Now you could do this,
and go ahead, support yourself on the table. So at home you might do this
at your kitchen table, place a chair
in this orientation. You now will begin to step away, and as you step away, let’s stop right about there, you’re going to lean forward. And that’s probably
about how far you may get before you feel discomfort. Again, the idea is
you get to the point, you feel some discomfort. You hold that position
for 10 to 15 seconds and then
you would walk back up. All right. Stand up so that you’re not getting back pain. Repeat the process, okay. If you can get further back,
then do so. I’m going to have you do it
one more time. So hand is on the table
to support your body weight. Put one leg behind you
and then lean over. The weight is moving away. You’re not pushing
into this hand, all right. The weight is moving away. Get to the point where
you can get good elevation. The angle between your arm
and your body is increased. Ten, 15 seconds. Repeat that 10 times,
doing that 3 times a day. These exercises will guide you through the first six weeks
of your rehabilitation, and they’re really critical
to maintaining motion, yet at the same time,
protecting tissue. Once you’re through
this first six weeks safely, we’re going to
move on to exercises that include active-assistive
range of motion, active range of motion,
and resistive exercise, and we’re going to show you
that in the next video.