You have just undergone shoulder surgery and rehabilitation is considered immediately, according to your surgeon’s opinion and confirmation
You will find in the blue boxes the different phases of rehabilitation according to the profile of your intervention.
This is an aid and a guide for you but also your physiotherapist if the medical prescription was not legible or available.
This passive phase will last 2 to 3 weeks.
Relaxation plays a key role in avoiding too early involvement of the tendons.
Rehabilitation begins immediately after the intervention by a passive mobilization soft and painless as well as the learning of the exercises of self-rehabilitation (exercise of the pendulum and movement aiming to seek the previous elevation).
Figure 1: exercise of the commuter
Figure 2: Manual passive mobilization performed by the physiotherapist masseur
Figure 3 Dujarrier splint
The MK will place particular emphasis on learning the relaxation needed for painless mobilization and the importance of multi-day self-mobilization. Clinic sessions will be punctuated with many tips on the implementation of your splint (elbow body type DUJARRIER) and constraints related to daily life.
When you leave hospital, the sessions will continue with your physiotherapist at a rate of 4 to 5 times a week, following the same protocol. Your mk will offer a passive manual mobilization and will help you to progress in your self-rehabilitation exercises. It will be able to propose you exercises with the objective of the recovery of amplitudes while respecting the notion of auto-passive. Sedative techniques can be proposed to you.
Figure 4: Passive mobilization exercise using a skateboard
It is actually an active-assisted / active phase.
This phase will last approximately 2 to 5 weeks.
During the 2nd phase, your physiotherapist will ask you for an active participation during the mobilization of your shoulder.
In progression, it will decrease the help that it brings you to obtain an active mobilization in all the amplitude. New self-rehabilitation exercises will be taught.
Figure 1: Active exercise aided by anterior elevation
after 4 to 6 weeks postoperatively and the green light of your surgeon, the physiotherapist will be able to begin this necessary phase to the total indolence and to the good functioning of your shoulder.
Obviously, this phase will be adapted to your daily activity. Your physiotherapist will take care to strengthen not only the muscles that lower the shoulder, but also the infraspinatus and small round muscles (often deficient), but also the muscles that provide the mobility and stability of the scapula on the rib cage.
He will correct if necessary the rhythm between the scapula and the humerus, often asynchronous because of suffering and preoperative compensation.
Figure 1: Solicitation Work of the Shoulder Stabilizers
This passive phase will last 1 month.
Relaxation plays a key role in avoiding too early involvement of the tendons.
Rehabilitation begins immediately after the intervention by a passive mobilization soft and painless as well as the learning of the exercises of self-rehabilitation (exercise of the pendulum and movement aiming to seek the previous elevation).
Figure 1: exercise of the commuter
Figure 2: Manual passive mobilization performed by the physiotherapist masseur
Figure 3 Dujarrier splint
The MK will place particular emphasis on learning the relaxation needed for painless mobilization and the importance of multi-day self-mobilization. Clinic sessions will be punctuated with many tips on the implementation of your splint (elbow body type DUJARRIER) and constraints related to daily life.
When you leave hospital, the sessions will continue with your physiotherapist at a rate of 4 to 5 times a week, following the same protocol. Your mk will offer a passive manual mobilization and will help you to progress in your self-rehabilitation exercises. It will be able to propose you exercises with the objective of the recovery of amplitudes while respecting the notion of auto-passive. Sedative techniques can be proposed to you.
Figure 4: Passive mobilization exercise using a skateboard
It is actually an active-assisted / active phase.
This phase will last approximately 2 to 5 weeks.
During the 2nd phase, your physiotherapist will ask you for an active participation during the mobilization of your shoulder.
In progression, it will decrease the help that it brings you to obtain an active mobilization in all the amplitude. New self-rehabilitation exercises will be taught.
Figure 1: Active exercise aided by anterior elevation
after 8 weeks postoperatively and the green light of your surgeon, the physiotherapist will be able to begin this necessary phase to the total indolence and to the good functioning of your shoulder.
Obviously, this phase will be adapted to your daily activity.
Your physiotherapist will take care to strengthen not only the muscles that lower the shoulder, but also the infraspinatus and small round muscles (often deficient), but also the muscles that provide the mobility and stability of the scapula on the rib cage.
He will correct if necessary the rhythm between the scapula and the humerus, often asynchronous because of suffering and preoperative compensation.
Figure 1: Solicitation Work of the Shoulder Stabilizers
Figure 2: work of the lower trapezius muscle
We commonly practice 2 types of intervention to stabilize the shoulder:
Your surgeon will choose one of these 2 interventions and will explain you his choice as well as the details of the intervention concerning you.
We will use the same rehabilitation protocol for both interventions.
The duration of this rehabilitation will be about 3 months minimum.
It will begin as soon as you are hospitalized and this until the 30th day postoperative. A DUJARRIER type immobilization is necessary the first month in order to let the tissues heal.
It will consist mainly of passive mobilization movements carried out by the physiotherapist masseur and aimed at recovering all the amplitudes of your shoulder
After the first postoperative appointment with your surgeon at the end of the first month, the immobilization splint can be removed and you can begin to use the shoulder. This 2nd phase will last until the end of the 2nd month.
Your physiotherapist massager can undertake an active mobilization of all the joints that make up the shoulder.
In addition, it can be undertaken early work rotator cuff tendons that are largely responsible for the stability of your shoulder. This early work will be performed only at 30 ° abduction and always recruiting the muscles through alternations of compression / traction exerted by the MK in the axis of the humerus. This work should not cause pain.
Your physiotherapist massager can undertake an analytical reinforcement of the motor muscles of the shoulder as well as a more specific work of destabilization aiming to train your shoulder to potential instabilizing gestures. Exercises including gestures of throwing and arming will be proposed to you to get closer to the sporting gesture.
Your surgeon will choose a type of total shoulder prosthesis (PTE) or not adapted to your case (either called anatomical or inverted).
Depending on the type of ETP chosen, the splint that will be proposed to you may vary (either elbow to the body or spreading the elbow of the body).
This passive phase will last 1 month.
recovery of passive amplitudes up to 30 days postoperatively.
The day after the intervention, a passive gentle mobilization will be started. It will be limited to 100 ° of lateral and anterior elevation and will always be infra-painful.
The exercise of the pendular as well as the setting up of the splint will be taught to you. Many tips will be given only during your hospitalization regarding daily life.
During this first phase, your physiotherapist may ask you for an active participation always painless and limited in terms of amplitude.
Fig, 1: manual passive mobilization
up to 5 to 6 weeks post op
Your kinesitherapist (MK) massager will recover the end of the amplitude and will ask you for a more active participation during the exercises.
He can start strengthening muscles stabilizing the scapula.
In progression, the MK will offer exercises to be performed daily for muscle strengthening. On an inverted type prosthesis, the deltoid reinforcement will remain the main objective since it is often the only motor of the elevation of the shoulder.
Your MK will take care not to over-apply the implant during this rehabilitation.
This last phase, in addition to the recovery of a normal scapula / humerus rhythm, will aim to adapt the movements of your shoulder in the tasks of daily life.
