Shoulder Rehabilitation Exercises | Part 3 | Shoulder Surgery Rehab Examples | Colorado

this section is to provide some information about the initial post
operative exercises
the first exercise is the neck exercises we do this to stretch out the neck
typically because people will get
pretty sore from wearing a sling for a long period time especially up in these
muscles
or these muscles
to do this turn to the left this is left rotation lindsey will turn to the left twice
this is right rotation turning to the right
two times like that
and you have lateral flexion of the neck
ear to shoulder
twice like that
this will especially stretch out these muscles
right rotation right lateral flexion, sorry
flexion of the neck lets bring the neck down
twice like that
an extension of the neck extending the neck
is simply looking up at the sky if you have neck problems be sure to be aware
so that you don't create any pain with this exercise if you do it's not necessary to do it
next exercise
is the assisted elbow flexion
grab the arm
and assist your arm into
elbow flexion
this is elbow flexion
typically the biceps will need to be active to do this exercise
to do this exercise actively
simply take away the hand
allow the arm to bend on its own
again this will assist with the pumping action that
pulls the swelling out of the shoulder and the arm
and helps to keep the bicep muscles active
the next exercise is hand
wrist and elbow movements
let's have you hold your hand like this
activity is allowed in the wrist and the elbow
to move the wrist
going to extend the wrist point back
flex it back and forth like that
turning the wrist
opening and closing the fingers as if you're making a fist
and relaxing
the next exercise is the ball squeeze
you will be provided with a ball on your ultra sling the purpose of the ball is
to pump the arm muscles
you hold this
so that any edema or swelling that comes down into the arm of the hand
gets pumped
out of the
the upper extremity
go ahead pump the ball
there's no limit to the amount of repetition you do with this you can do
this all day long if you like
again it is
to pump the swelling right back out of the arm
toward the heart
next exercise is the pendulum
to do this exercise properly let your
arm hang
and make small circles you're going to use your body weight to make the circles
as not activate the rotator cuff muscles
simply just sway forward
and back
oftentimes this exercise will help with pain relief
and is a nice warm up to the any of the passive or active exercise you do
as a part of your post operative rehabilitation
the next exercise the ankle pump
the purpose of the ankle pump is to prevent deep vein thrombosis
that is a DVT
DVT is a blood clot that may form in your calf muscle
it's very dangerous because if you do get a DVT it could become loose and
create a pulmonary embolism which is a blood clot that would go up to your
lungs and
it could be fatal so
what we ask our patients to do as much as possible
is to place a thera-band around their foot
hold with their uninvolved arm
hold tight and lindsay lets just have you pump your foot up and down
by pumping the calf muscles
you pump blood through the calf muscles
and creative increased amount of circulation as to
keep blood clots from forming in the calf muscles
this exercise can also be done without thera-band
so lets have you pump
and with an increased amount of walking this will also help
to increase circulation of the calf muscles as well so this is also
encouraged
so lindsay let's talk a little bit about DVT prevention so we talked about
that
in the post op exercises we did your ankle pumps that's where you are moving
your feet up and down either with or without the thera-band and that's going
to put help promote circulation in your lower extremities other things you'll
be provided with are a pair of T.E.D. hose these are white stockings that you got right
after surgery that you woke up with
we'd like you to wear those for at least ten to fourteen days and anytime you will be
traveling in the car on an airplane for long periods of time
and of course we're going to try to start you on some type of cardiovascular
exercise as soon as possible and that will also help promote circulation
whether it be walking or riding a stationary bike you may not want to do
anything to jarring in the beginning because you just had shoulder surgery
and those are things that will help prevent deep vein thrombosis
next exercise we will go over is passive range of motion exercises
passive range of motion means that you're not using your muscles as we do
the motion for you
the reason we have you do these exercises to help increased range of
motion
move the joint so that the synovial fluid circulates inside the joint
thus promoting nourishment of the joint and promoting circulation of the tissue
surrounding the joint
the next exercise is passive external rotation to do this you have your
patient lying on their back
with a towel support under their arm
external rotation is the motion where you move the shoulder outward like this
you see the humerus bone
turns on an axis
where you don't abduct or elevate the shoulder so it goes just like this
we measure external rotation starting
from here with the fingers pointing up toward the sky
at zero degrees this is zero degrees if we move out externally just a bit
this is thirty degrees
this would be forty five
sixty and ninety degrees of external rotation
while doing this exercise be sure that your patient does not
guard with their muscles contract their muscles
or have any major increases in pain while doing the exercise
as we move the shoulder to the inside this can be considered
internal
rotation
so internal rotation and external rotation can be combined during this exercise
an alternative to doing this exercise to actually take the pillow away
or the towel roll
and sit next to the patient
have their elbow right on your thigh
you can place your hand on the shoulder for support or keep it here
and externally rotate
and thats external rotation in a passive range of motion
the next exercise we will do is for elevation
from here we can take the elbow hold onto it firmly
bring the arm
into forward elevation
again it's important that the person does not contract the muscles while
during this exercise
sometimes it's helpful to have bend in the elbow
pull the arm close
and maintain some contact with the glenohumera joint
just like this
again if you feel that the person's contracting the muscle simply stop
let them relax
and then continue with the motion
be careful when you're lowering the shoulder
as lowering the shoulder is an anti gravity motion
when you lower a shoulder the person has a tendency to contract the muscles
when they do this they will
probably create a bit of pain in the shoulder so
be sure that you're slow with the lowering motions
and very supportive
from this position we can go to abduction lindsay i will have you hold onto my arm
lindsay's holding onto my forearm here
i'm holding on to her elbow
one hand here
and we bring her arm into abduction like this
this motion again is called abduction abduction means to move away from the
body
dont help me too much
be sure not to just let go of the arm
hold on to it firmly
position of support
help your subject, patient, friend, spouse
back into a comfortable resting position