Rehabilitation begins almost immediately after surgery.
The shoulder is the only joint in the human body with the ability to rotate 360 degrees---both backward and forward---as well as flex and extend. This wide range of motion places the shoulder at increased risk of injury and loss of stability. Strengthening the muscles of the rotator cuff will help prevent injury, but if you do injure your shoulder and require surgery the following exercises will likely be an important component in your rehabilitation program.
Six to Eight Weeks Post-Surgery
Post-surgery range-of-motion exercises usually begin under the care of a physical therapist about six weeks after your operation. A physical therapist typically will administer scar tissue massage, ice therapy and soft tissue manipulation, while you will be responsible for following a home exercise program that will require a commitment of 10 to 15 minutes two to three times per day.
The pendulum swing is generally one of the first exercises prescribed to loosen shoulder muscles, relieve pain and stiffness, and increase range of motion after weeks of immobilization. To perform the swing, hold onto the edge of a table or sturdy chair with your good arm and bend forward at the hips. Keep your knees slightly bent to reduce pressure on the lower back. Relax the injured shoulder, letting the arm hang limply towards the floor. Begin to rock your body (not your arm) so that the hanging arm rotates in small circles. Do 20 to 30 rotations in each direction, gradually building up to 2 minutes.
Supine assisted shoulder flexion involves using the good arm to help increase range of motion in your injured shoulder. Lying on the floor or a bed with your knees bent and feet flat, hold a dowel stick in both hands. Using your good arm to control movement, slowly lower the dowel and your arms to the floor overhead. Work within a comfortable range of motion, increasing it gradually with the goal of touching the floor.
Eight to 12 Weeks After Surgery
Exercises will become more demanding as your range of motion improves and strength increases. As you will require less assistance from your good arm, your exercises will incorporate isometrics and active movements that utilize rubber tubing or light dumbbells to increase strength.
For instance, wall walking is a popular and effective exercise. Stand facing a wall with your arm extended and your palm on the wall. Keeping your elbow straight, use your fingers to "walk" your arm up the wall as far as possible. Hold it at the highest position for 10 to 15 seconds, then return to the starting position. Do this three to five times.
Another is the isometric external rotation. Stand with the injured arm against a wall with the elbow bent at a 90-degree angle. Push the arm against the wall as firmly as possible, hold it for a count of five, then relax. Do this 10 to 12 times.
You should also try to incorporate the standing flexion using a dowel stick. Stand upright with your shoulders back while holding a dowel in your hands in a palms-up position and your elbows locked. Slowly raise the stick up towards the ceiling as high as possible without rocking backwards. Make sure you engage your abdominals to support your back as you lift.
Finally, standing rotations using a dowel stick requires you to stand with your elbows straight out to the sides while holding a dowel in both hands. Slowly turn the stick upward toward the ceiling, then rotate your shoulders so the dowel drops to your waist. Your elbows should stay bent at 90-degree angles throughout the movement.
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