Shoulder replacement protocol call now 2068605578 when a persons shoulder is injured, it affects their range of motion, limiting their ability to perform regular activities like lifting, exercising, or playing sports. Rehabilitation protocol for total shoulder arthroplasty. The physician reserves the right to either advance or delay this protocol. Total shoulder replacement johns hopkins shoulder and elbow. Reahabilitation following reverse total shoulder arthropoplasty. Variances will be communicated by the surgeon directly to rehabilitation services. Shoulder arthroplasty protocol shoulder arthroplasty protocol this rehabilitation protocol has been developed for the patient following a shoulder arthroplasty replacement procedure. Reverse total shoulder replacement postop protocol penrose. Rehabilitation protocol for reverse shoulder arthroplasty. Journal of orthopaedic and sports physical therapy. This is because the articular surface of the round. Shoulder movement coordination deficits pdf download shoulder pain pdf download shoulder and related upper extremity radiating pain pdf download cervical and shoulder region algorithms pdf download shoulder infraspinatus stm mpeg movie shoulder subscapularis stm mpeg movie shoulder humeral posterior glide mpeg movie.
Minimize heavy, excessive cyclic loads for the first 6 months. Paff the intent of this protocol is to provide the clinician with guidelines of the postoperative rehabilitation of someone undergoing total shoulder arthroplasty or hemiarthroplasty. Many patients with reverse total shoulder replacements can elevate their arm above shoulder level. Shoulder replacement rehabilitation phase 2 shoulder. Shoulder replacement surgery replaces damaged joint surfaces. However, unlike a typical total shoulder replacement these patients tend to have limited active external. Uw health s sports medicine sports rehabilitation physical therapists and athletic trainers in madison, wisconsin, help injured athletes return to. However, anyone recovering from an injury or surgery is free to use them. Rehabilitation protocol for total shoulder arthroplasty and hemiarthroplasty this protocol is intended to guide clinicians and patients through the postoperative course after a total shoulder arthroplasty tsa and hemiarthroplasty. Avoid shoulder ext past neutral for 12 weeks avoid internal rotation, adduction and extension as patients have a high likely hood of dislocation with combined movements.
Total shoulder replacement johns hopkins shoulder and. Rehabilitation protocol for reverse shoulder arthroplasty this protocol is intended to guide clinicians and patients through the postoperative course after a reverse shoulder arthroplasty. Specific interventions should be based on the needs of the individual and should consider exam findings and clinical decision making. Presence of a functional rotator cuff intact or repaired type of shoulder replacement anatomic or reverse presence of a. Department of rehabilitation services reverse total. Reverse total shoulder replacement postop protocol. The top of the humerus is replaced with a socketlike prosthetic and the shoulder s socket is replaced with a prosthetic ball.
Rehab after total shoulder replacement physical therapy. Rehabilitation protocol for total shoulder arthroplasty and. Shoulder replacement surgery relieves pain and helps restore motion, strength and function of the shoulder. Patient is able to maintain painfree shoulder arom typically 80120 of elevation, with functional er of about 30 2. The information contained in these standards of care or protocols is not intended in any way to be used as primary medical advice or to replace medical advice offered by physical, occupational, speech therapists or other health care professionals.
Maintenance of good postural positioning when performing all exercises. The physician reserves the right to either advance or delay this protocol as deemed necessary. Our shoulder specialists have performed numerous shoulder replacements at johns hopkins and appreciate an opportunity to share their knowledge. The timing of recovery and ultimate outcome following reverse shoulder replacement is variable, often depending to some extent on the integrity of remaining rotator cuff musculature.
The head of the upper arm bone humerus is the ball and a circular depression glenoid in the shoulder bone scapula is the socket. Progressing too quickly, even though it may feel okay at first, may put you at risk for injury. Rehabilitation following total shoulder arthroplasty. The intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient that has undergone a total shoulder arthroplasty tsa or hemiarthroplasty humeral head replacement, hhr.
They have provided answers to some of the most frequently asked questions about the. Use sling continuously except while doing therapy or light, protected activities. Gentle closed kinetic chain shoulder and scapular stabilization drills wall ball. Use of a sling for 3 weeks postop unless otherwise indicated. Gradual increase of activities from supine to vertical i. Rehabilitation protocols ohio state sports medicine. Apply ice, or the cooling unit, to the shoulder as it will be quite helpful. Dr brian badman offers arthroscopic superior capsular repair in carmel, fishers, terre haute, kokomo, brownsburg and franklin in indiana. The intent of this protocol is to provide the physical therapist with a guidelinetreatment protocol for the postoperative rehabilitation management for a patient who has undergone a reverse total. Sling worn continuously for 34 weeks, no shoulder arom, no lifting of objects. The intent of posting these standards of care and protocols is to provide clinicians and patients. In this approach, the arthritic ball and socket are removed and replaced with a metalandplastic shoulder joint.
The material presented here is for informational purposes only and is not intended to serve as an exercise program. Reverse shoulder arthroplasty physical therapy protocols. Ohio state physicians and physical therapists work collaboratively to develop best clinical practices for postsurgical rehabilitation. Reduce pain, inflammation and muscular inhibition, increase prom of shoulder, allow healing of soft tissue. This protocol will vary in length and aggressiveness depending on factors such as. Rehabilitation guidelines for shoulder arthroplasty and reverse ball and socket arthroplasty the anatomic configuration of the shoulder joint glenohumeral joint is often compared to that of a golf ball on a tee. Maintain surgical motion early, but protect subscapularis repair by avoiding.
Patient demonstrates proper shoulder mechanics references bourdreau s, bourdreau e, higgins ld, and wilcox rb. Rehabilitation after total shoulder arthroplasty activities and advice for in the hospital and while at home. Total shoulder arthroplasty hemiarthroplasty protocol. The actual post surgical physical therapy management. Reverse total shoulder replacement therapy protocol.
After removing the sling, start motion exercises exercises 49 in this video. For patients who are recovering from shoulder surgery, please refer to the following protocols as advised by your physical therapist. Total shoulder replacement is a highly successful procedure to reduce pain and restore mobility in patients with endstage shoulder arthritis and, in some cases, after a severe shoulder fracture. Reverse or inverse total shoulder arthroplasty rtsa is designed specifically for the treatment of glenohumeral gh arthritis when it is associated with irreparable rotator cuff damage, complex fractures as well as for a revision of a previously failed conventional total shoulder.
Dont miss this simple breakdown of recovery time for. This is because the articular surface of the round humeral head is approximately four times greater than. Postoperative rehabilitation protocols shoulder shoulder arthroscopy general slap or anterior labral repair posterior labral repair rotator cuff repair cc ligament reconstruction latarjet procedure pec tendon repair pec tendon transfer total shoulder or reverse shoulder arthroplasty knee knee arthroscopy general knee microfracture or oats meniscus repair meniscus root repair mpfl. Rehab protocols arthroscopic superior capsular repair. T physical therapy, protocols, shoulder rehabilitation he first total shoulder arthroplasty tsa was performed by jules emile pean in 1893 for the purpose of treating tuberculous arthritis of the shoulder. Shoulder replacement rehabilitation program johns hopkins. This option is ideal for individuals with damaged rotator cuff muscles. Shoulder examination tests 15032020 diagnose your shoulder this is an interactive guide to help you find relevant patient information for your shoulder problem. Specific interventions should be based on the needs of the individual and. Shoulder replacement surgery types, common questions. Most therapy regimens, particularly after shoulder replacement. Therapeutic exercise o grip strengthening o pulleyscane o elbowwristhand exercises o teach home exercises pendulums. Total shoulder arthroplastyhemiarthroplasty protocol. This protocol is intended as a general guideline for the therapist in directing the postoperative rehabilitation course following a reverse shoulder replacement.
Reverse total shoulder replacement rtsr is designed specifically for the treatment of glenohumeral gh arthritis when it is associated with irreparable rotator cuff rc damage, complex fractures as well as for a revision of a previously failed conventional total shoulder. Total shoulder arthroplasty total shoulder arthroplasty, or tsa, is a procedure used to replace the diseased or damaged ball and socket joint of the shoulder with a prosthesis made of polyethylene and metal components. It is not intended to be a substitute for special instructions from. It is not intended to be a substitute for appropriate clinical decisionmaking regarding the progression of a patients postoperative. Shoulder arthroplasty protocol northeast orthopedics and. One of the scapular muscles is the serratus anterior muscle which is an important muscle to keep strong in order to maintain a healthy, stable shoulder. It is not intended to be a substitute for appropriate. Total shoulder arthroplasty protocol boston shoulder institute.
The following shoulder stretching and strengthening exercises, which are. The rehabilitation protocol for total shoulder arthroplasty tsa hemiarthroplasty hhr is based on the latest research. Rehabilitation guidelines after surgery, sports medicine. The goal of this protocol is to slowly advance range of motion and strength while avoiding dislocation of the shoulder replacement. Reverse total shoulder replacement therapy protocol general information. Sep 06, 2016 most therapy regimens, particularly after shoulder replacement surgery, are based on a healing timeline. Total shoulder replacement surgery your shoulder is a ballandsocket joint. The top of the humerus is replaced with a socketlike prosthetic and the shoulders socket is replaced with a prosthetic ball. It replaces the ball at the top of your humerus with a metal ball, which gets attached to the remaining bone.
Passive forward flexion, er, and ir in scapular plane, pendulum exercises, and arom of distal extremity. This protocol was adapted from the articles titled. Duke shoulder surgeons have extensive experience performing this procedure, which has been in use for more than 30 years. Shoulder replacement protocol call now 2068605578 when a persons shoulder is injured, it affects their range of motion, limiting their ability to perform regular. Total shoulder replacement postop physical therapy protocol.
The intent of this protocol is to provide the therapist with a guideline for the postoperative rehabilitation course of a patient that has undergone a total shoulder arthroplasty tsa or hemiarthroplasty humeral. Exercises for recovery from total shoulder replacement. Total shoulder replacement protocol sports and orthopedic. Total shoulder replacement postop protocol 20191021t15. Adduction holding on to the end of the wand with the right hand, right elbow slightly flexed, left hand is on the mid shaft on the wand and pulls right shoulder across the body for exercising an involved right shoulder, reverse hands for an. Department of rehabilitation services reverse total shoulder. American shoulder and elbow surgeons standardized shoulder. In tsa, the current components of the glenoid are either a pegged or keeled highmolecular weight polyethylene cemented component. Slucare sports medicine and shoulder surgery specialists developed the following physical therapy protocols for slucare clinicians to use when recommending treatment and rehab for slucare patients. Rehabilitation guidelines for shoulder arthroplasty and. Reverse total shoulder arthroplasty rtsa is designed specifically for the treatment of glenohumeral shoulder arthritis when it is associated with irreparable rotator cuff damage, complex fractures as well as for a revision of a previously failed conventional total shoulder arthroplasty.
Rehabilitation after total shoulder arthroplasty dr. Total shoulder replacement physical therapy protocols dr. Shoulder arthroplasty and reverse ball and socket arthroplasty. Shoulder arthroplasty the shoulder is a ball and socket joint that enables you to raise, twist, bend and move your arms forward, to the sides and behind you. The path to regaining range of motion, strength and function can require a sustained and coordinated effort from the patient, his or her family, the ohio state sports medicine physical therapy team and sometimes, other healthcare providers. The best way to get all of your questions answered and get on the road back to a healthy, active lifestyle is to simply call 18003219999 and schedule an appointment with a specialist at rothman orthopaedic institute. Total shoulder replacement is a complex procedure that involves replacing the shoulder joint with artificial parts. May, 2010 this video series demonstrates the stages of rehabilitation you are likely to experience following a total shoulder replacement tsr. Reverse total shoulder replacement is the best option for patients failing nonoperative management of severe arthritis and a large rotator cuff tear, particularly in patients who are in their 60s or older.
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