Rotator Cuff Repair
Recovery Timeline
Treatment: Regain full passive motion using twice daily stretching exercises. The stretches should focus on internal rotation, external rotation and forward elevation and they should only consume 15 minutes of the patient’s time to do them all. Once passive motion is normal, start an isometric strengthening program without therabands. No external rotation past neutral or away from the body. No exercises should cause pain.
If the patient is unable to elevate the arm above shoulder height without weights, then a supine strengthening program should be started.
Duration: 2 times a week for 8 weeks.
Modalities may be used as indicated.
This includes biceps tendon repairs done at the same time.
- First 2 weeks: keep the sling on except for showers and stretching. Bend the elbow twice a day. No reaching, lifting or pushing. You will be able to type on a keyboard as long as you bring the keyboard to your lap so you don’t have to reach with your arm. You can use your hand to hold a phone, but nothing more.
- 2 weeks: You will start therapy so they can teach you the stretches to do at home 3 times a day. Bend the elbow twice a day. Keep the sling on all other times. You may drive if you are no longer taking pain medications and you keep your arm in the sling.
- 6 weeks: stop using the sling. No lifting more than a coffee cup with the arm. You will continue with therapy and you will start stretching the arm behind your back.
- 12 weeks: continue stretching. Most patients are able to get their hand above their head and to their belt behind their back. The motion will not usually be the same as the other shoulder by this time. It is ok to start lifting 5lbs occasionally, but no repetitive lifting yet. You will start a strengthening program with your therapist.
- 5-6 months: Most patients can do normal activities around the house and office at this time. High level sports like golf, basketball, tennis and swimming can start now. Most patients are able to transition to doing all their exercises at home by this time and graduate from physical therapy.
Therapy Instructions
Exercises
Anatomic Total Shoulder
Recovery Timeline
- Day of Surgery: The surgery will take two hours and you will wake up in the recovery room. After an hour in the recovery room, you will go to your hospital room to see your family. They will be given something light to eat and drink at first before eating regular meals. You will be able to get out of bed and walk to the bathroom. If you are feeling comfortable, you can go home that same day. If you are having too much pain or are not feeling well, you will stay the night and go home the next morning.
- First 2 weeks after surgery: You will wear a sling at all times except during showers and you stretching exercises. You cannot reach to pull up your pants or lift anything. You can use the hand to type if you move the keyboard to your lap. You will start stretching exercises three times a day by following the exercise videos on this website.
- 2-6 weeks: You will start formal therapy after your first postop visit in the office. You will wear a sling as a reminder not to reach or lift the arm so that you protect the repair of your shoulder. If it doesn’t heal because you moved it too soon, you will not get a good result.
- 6-12 weeks: You will stop using the sling. You can reach and lift a coffee cup with the arm. Stretching will be continued three times a day and you will start stretching behind your back.
- 3-6 months: You 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. You will start a gentle strengthening program in therapy and after a month, you will graduate from therapy to a home exercise program.
- One year: By this time, most patients have made a complete recovery.
Reverse Total Shoulder
Recovery Timeline
- Day of Surgery: The surgery will take two hours and you will wake up in the recovery room. After an hour in the recovery room, you will go to your hospital room to see your family. They will be given something light to eat and drink at first before eating regular meals. You will be able to get out of bed and walk to the bathroom. If you are feeling comfortable, you can go home that same day. If you are having too much pain or are not feeling well, you will stay the night and go home the next morning.
- First 2 weeks after surgery: You will wear a sling at all times except during showers and you stretching exercises. You cannot reach to pull up your pants or lift anything. You can use the hand to type if you move the keyboard to your lap. You will start stretching exercises three times a day by following the exercise videos on this website.
- 2-6 weeks: You will stop wearing the sling and you will start a home stretching program. You are not allowed to lift more than a coffee cup with the arm. If you start to lift too much too fast, you could get a stress fracture of your shoulder which can take a few months to heal.
- 6-12 weeks: You can start to lift 5lbs with the arm and gradually return to your normal activity. You should not need formal therapy unless you are having trouble with your stretching exercises.
- 3-6 months: Most patients are feeling much better and can sleep on the shoulder.
- One year: By this time, most patients have made a complete recovery
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 Postoperative
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 therapy with your therapist so you can learn the stretching exercises that you will need to do at home 3 times a day. You cannot do any lifting with the arm or hand. Keep the arm in the sling all other times.
- 4 weeks: You can now stop using the sling and you can lift a coffee cup with the arm. Continue with your physical therapy visits and start stretching the arm behind your back.
- 10 weeks: Now you can start a strengthening program for the shoulder and the biceps. You may gradually increase the weight you lift as pain allows.
- 4 months: Most patients are able to normal daily activity around the house and at the office with minimal pain. You can start working towards getting back to your usual sport like swimming, tennis or golf.
Labrum Repair Postoperative
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 Fracture Repair
Recovery Timeline
- First 4 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. You can type with your hand and hold a cell phone.
- 4 weeks: 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.
- 10 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.
Instability Repair
Recovery Timeline
- First 6 weeks: You will be in a sling to protect your repair. You can use a keyboard if you pull the keyboard into your lap and you don’t reach with the arm. You will take the sling off to shower and move your elbow a few times a day. No reaching lifting or pulling with the arm.
- 6 weeks: You will stop using the sling and start a stretching program with physical therapy. The first goal is to regain your motion in your shoulder before you start a strengthening program.
- 10 weeks: You will start a strengthening program with your therapist and you will learn the precautions that you must take to protect your repair.
- 4 months: You will be able to return to sports like golf and biking.
- 6 months: You will be able to return to contact sports if your strength in the arm is equal to the other side. You can also return to swimming and throwing sports at this time.