Physical Therapy Instructions

Bone Spur Removal

Recovery Timeline

  • 2 days: Stop using the sling and use the arm with light activity. No lifting more than 5lbs.
  • 2 weeks: start stretching the shoulder to regain motion.
  • 6 weeks: start strengthening the shoulder with therapy
  • 12 weeks: The shoulder will still have pain, but it should be better than 6 weeks ago.
  • 6 months: Most patient are back to light or medium duty jobs. Patients who need to do heavy lifting will need more time before they can return to work full duty.
  • One year: most patients have 80-100% pain relief at this time and can do most activities.
Counter top shoulder stretches

Biceps Repair

Recovery Timeline

This includes patients who had bone spurs removed. Go to the rotator cuff repair timeline if a cuff repair was done at the same time at the biceps repair.

  • First 2 weeks: keep the arm in the sling except for showers and stretching the elbow. Bend the elbow with the help of the other hand twice a day.
  • 2 weeks: start counter top stretching and external rotation stretching three times a day. Bend the elbow three times a day using the other hand to help so you don’t pull on the biceps repair. No lifting any weight with the arm or hand. Keep the arm in the sling all other times.
  • 6 weeks: Start physical therapy now. Stop using the sling. OK to lift 2-3 lbs with the arm. Start stretching the shoulder with supine elevation stretching, external rotation stretching and internal rotation stretching.
  • 10 weeks: start strengthening program for the shoulder and the biceps. You may gradually increase the weight you lift as pain allows.
  • 6 months: It is normal to still have some pain at this point. Most patients are able to return to light or medium duty jobs by this point. Heavy duty jobs will require more therapy and can take 9-12 months before going back without restrictions.
  • One year: Most patients have 80-90% pain relief by this time.

Rotator Cuff Repair

Recovery Timeline

  • First 2 weeks: Keep the arm in the sling except for showers and stretching the elbow. Bend the elbow twice a day.
  • 2 weeks: start stretching the shoulder with a counter top stretch twice a day. Keep the arm in the sling until 6 weeks after surgery. No reaching, lifting or pushing.
  • 6 weeks: start physical therapy. Start stretching the shoulder three times a day with supine elevation stretching, external rotation stretching and internal rotation stretching. You can stop using the sling. You can reach with the arm, but no lifting more than a coffee cup until 12 weeks after surgery.
  • 12 weeks: continue to stretch the shoulder three times a day. You can lift up to 5lbs with the arm occasionally, but no repetitive reaching or lifting.
  • 16 weeks: start a strengthening program with therapy. Start with waist level strengthening with forward and backward rowing exercises. You can also strengthen the biceps and triceps. Move on to forward elevation strengthening and external rotation strengthening in a few weeks. Use pain as your guide. If an exercise causes pain, then stop. Soreness is OK to work through.
  • 6 months: You will be able to return to golf or tennis at this point if you are doing well with your exercises and you have nearly all your motion back in the shoulder.
  • 1 year: Most patients have 80-90% pain relief by this time.

Therapy Instructions

Exercises

Supine elevation stretching
External Rotation Stretching
Counter top shoulder stretches
Internal rotation stretching

Labrum Repair

Recovery Timeline

  • First four weeks: Keep the arm in the sling. No reaching, lifting or pushing with the arm. You may bend your elbow and use the hand while the arm is in the sling.
  • 4 weeks: stop using the sling. Start using the arm for light activities like reaching in front of the body. No reaching away from the body and out to the side at the same time. Start physical therapy to learn how to stretch the shoulder in safe positions.
  • 8 weeks after surgery: start strengthening the shoulder with your therapist. Continue with a stretching program to regain all of your motion.
  • 12 weeks after surgery: now you can reach out to side without restriction and continue to strengthen the shoulder with more resistance.
  • 6 months after surgery: if your strength is the same in both shoulders, they you can return to contact sports.

Clavicle Repair

Recovery Timeline

  • First 6 weeks: your arm will be in a sling to protect the repair. You will take the sling off for showers and to bend the elbow a few times a day. Absolutely no reaching, lifting or pushing with the arm. You can move the arm away from the body to wash your underarm.
  • 6 weeks after surgery: if your xrays look good, you can stop using the sling. You can reach with the arm, but no lifting anything more than a coffee cup with the arm. You can start stretching the shoulder in all directions with the counter top stretch, internal rotation stretch, and external rotation stretch.
  • 12 weeks after surgery: if your xrays show healing of the fracture, you can start to return to your normal activities gradually.
  • Return to work: You can return to work within a few days after your surgery as long as you are no longer taking narcotic pain medications. You will be able to use the hand to type and write, but no lifting is allowed.

Total Shoulder

Recovery Timeline

  • Day of Surgery: The surgery will take two hours and patient will wake up in the recovery room. After an hour in the recovery room, patients will go to their hospital room to see their family. They will be given something light to eat and drink at first before eating regular meals. Patients will be able to get out of bed the night of the surgery.
  • The Day after surgery: Physical therapy will start to stretch the shoulder and the rest of the arm. Patients will learn how to do their exercises on their own.
  • 2 Days after surgery: Patients are usually able to go home as long as their pain is controlled with pain meds and they can get in and out of bed without using the operative arm. Patients will do their stretching exercises three times a day.
  • 2-6 weeks: Patients are able to use the arm for very light activities like eating and dressing. No lifting, reaching or pulling with the arm. Patients will wear a sling as a reminder not to reach or lift the arm.
  • 6-12 weeks: patients will stop using the sling. Patients can reach and lift up to 5lbs with the arm. Stretching will be continued three times a day.
  • 3-6 months: Patients will gradually return to normal activity as pain permits, starting with activities around the house and then eventually returning to golf and tennis no earlier than 4 months after surgery.
  • One year: By this time, most patients have made a complete recovery.
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