TOTAL SHOULDER/HEMIARTHROPLASTY: 140/40 ACTIVE … · TOTAL SHOULDER/HEMIARTHROPLASTY: 140/40...

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TOTALSHOULDER/HEMIARTHROPLASTY:140/40ACTIVEASSISTPROGRAM

PHASE1(0WKSTO6WKS):Holdeachstretchfor10seconds,perform3setsof10repetitions,3timeseachday.Nostrengthening,Nolifting>1lb.

GOAL:140degreesforwardelevationand40degreesexternalrotationattheside

Usingtheoppositearmforassistance,worktoelevateyourarmto140degrees.

Usingtheoppositearmforassistancewithanobjectsuchasacane,broomhandleoryardstick,worktoexternallyrotateyourarmatthesideto40degrees.

TOTALSHOULDER/HEMIARTHROPLASTY:140/40ACTIVEASSISTPROGRAM

PHASE2(6WKSTO12WKS):At6weeksprogressivestretchingisbeguntoachievefullmotionandencouragedaslongasitiscomfortable.Progressivesupinebenchisbeguntoregainforwardelevationstrength.Nointernalrotationagainstresistanceisallowedtopermitsubscapularishealing.

GOAL:Fullpainfreemotionoftheoperatedshoulderandabilitytoraisearmagainstgravitywhilestandingfullyupright.

Progressivesupinebench:Keyforregainingforwardelevationfunctionaftertheoperation.Inthefirstphase,thepatientliessupinewiththehandsclosetogetheronatowelorlightstick.Bothhandsarepresseduptowardtheceiling,finishingbyprotractionofthescapulaoffthetableasshownbelow.Inphasetwo,thehandsare

progressivelyseparated,allowingthemtoactmoreindependently.Inphasethree,onehandpressesalone.Inphasefour,weightisaddedtothehandinsmallincrementsuntiltheweighttotals2pounds.Inphasefive,thebackofthetableorchairorrecliner,isprogressivelyraiseduntilthepatientisinthesittingposition.Eachphaseiscontinueduntil20repetitionscanbeperformedeasilybeforethepatientadvancestothenextphase

PROTRACTIONOFTHESCAPULAATENDOFEACHREPETITION