York, ME (207) 363 3490 | Portsmouth, NH (603) 431 1121

SHOULDER CAPSULAR RELEASE – PHYSICAL THERAPY PROTOCOL

The rehabilitation program will be individually tailored by the therapist in close communication with the surgeon.

***The physical therapy MUST start the day after your surgery. You should make appointments in advance to begin physical therapy in time.
***For the first 3 weeks after surgery, you should see the physical therapist at least 4 – 5 times a week to maintain the maximum range of motion obtained during surgery (Note: The surgeon will specify the maximum motion obtained during surgery.)

Phase I: Immediate Postoperative Period: 0 – 3 weeks

• Wear the arm sling for comfort only. Remove the sling and move the arm frequently. No sling 2 weeks after surgery.

• Pendulum exercises 4 – 5 times a day

• Warming up exercises before starting ROM exercises (pendulum exercise, shoulder shrug, shoulder blade pinch, etc.)

• Passive/active assisted shoulder forward flexion in supine, with assistance of family member or therapist up to the maximum range obtained during surgery with emphasis on “terminal stretch”

• Passive/active assisted external rotation with cane or stick with shoulder abducted to 30 degrees in supine (with towel roll under elbow) up to the maximum range obtained during surgery with emphasis on “terminal stretch”

• Passive/active assisted behind-the-back internal rotation with cane or stick in sitting position as tolerated with emphasis on “terminal stretch”

• Ice 3 – 4 times a day

• Home use of modalities as needed to assist in pain relief

Phase II: Maintain ROM and Decrease Pain: 3 – 6 weeks

• No sling

• Continue pendulum exercises 3 times a day

• Continue PROM/AAROM to progress to full range of motion

• Add: -supine external rotation with abduction

-supine cross-chest stretch

-standing active assisted forward elevation

-standing external rotation

-Side-lying external rotation without weight

-prone horizontal abduction

• Ice 3 times a day

• Home exercise program

• Home use of modalities as needed to assist in pain relief

Phase III: Regain Full Motion and Begin Gentle Strengthening: 6 – 12 weeks

• Goal -Obtain full pain free passive and active range of motion

-Begin to restore proper scapulohumeral mechanics

-Independent ADLs

-Gentle strengthening

-Patient education/independence in home exercise program

• Continue the Phase II exercises

• Add -corner stretch

-wall climb

-standing active forward elevation

-Side-lying external rotation with 1 – 2 pound weight (10 repetitions)

-Theraband – Concentric and eccentric within pain-free ranges in all planes (Note: keep elbow flexed to 90 degrees for flexion and elevate only to 90 degrees)