SPORTS MEDICINE / SHOULDER SERVICE

GEORGETOWN UNIVERSITY MEDICAL CENTER

Total Shoulder Replacement / Hemiarthroplasty

 

 

 

 

John J. Klimkiewicz, M.D.

 

 

 

Phase I:  (0-3 weeks)

 

Goals: 

-         Patient Education

-         Allow healing of subscapularis

-         Control pain and inflammation

-         Initiate Range of Motion exercises

 

  1. Review precautions based on range of motion in OR (as specified on Rx.)
  2. Pendulums, elbow AROM, hand squeezes
  3. Supine passive forward elevation and passive external rotation within plane of scapula (see precautions)
  4. May add PROM in internal rotation and adduction

 

Patient may progress to ADL’s as tolerated

 

 

Phase II:  (3-8 weeks)

 

Goals:

-         Decreased pain and inflammation

-         Increased ADL’s

-         Continue stretching until full PROM achieved

-         Initiate strengthening

 

 

  1. Add Phase II stretching in planes of extension, internal rotation, elevation, external rotation  and posterior capsular stretch
  2. Initiate light isometrics for rotator cuff
  3. Progressive strengthening at 4-6 weeks
  4. Scapular stabilization

 

 

 

 

 

 

Phase III:  6-12 weeks

 

Goals:

-         PROM full and pain free

-         Increase functional activities

-         Increase strength of scapular stabilizers

 

 

  1. Continue strengthening.
  2. Progressive resistance of shoulder shrugs, scapular retraction, biceps, triceps.

 

 

 

Phase IV:  (12-16 weeks)

 

Goals:

-         Full functional activities

-         Return to work or sport

 

 

  1. Work or sport specific training
  2. Suggest modifications to work, sport, or functional activities

 

 

 

This protocol provides general guidelines for the rehabilitation of the total shoulder replacement/ hemiarthroplasty patient.  Specific changes in the program will be made to this protocol as appropriate for the individual patient  and will be specified on the accompanying prescription.  If  you have any questions regarding this protocol feel free to contact the physician at (202) 444-8613.