Postoperative rehabilitation plays a vital role in restoring daily activities after shoulder surgery. Follow your surgeon's instructions and work hard to achieve the best result.
Early rehabilitation.
Stretching and normal daily activities usually begin on the day of surgery. At your request, pain relief therapy can be prescribed. First of all, under the supervision of a rehabilitation physician, gentle rocking movements in the shoulder begin, giving the shoulder different positions to relax the muscles. These passive exercises help prevent stiffness while movement in the shoulder gradually returns. You also need to tense the muscles in your hand and forearm by flexing your wrist and elbow.
A rehabilitation doctor will show you the safest ways to get up and down in bed, sit on a chair or toilet. The rehabilitation therapist will track your daily progress and keep your surgeon updated.
Shoulder injuries
The shoulder girdle joint is the most mobile in the human body. Its unique structure allows movements in completely different planes. But this advantage also has a downside, because the shoulder joint is subjected to heavy loads and is often damaged.
The shoulder area is attached to the chest by the sternoclavicular joint, and the shoulder blade is connected only by muscle tissue.
The muscles not only generate movements, but also stabilize the dynamics of the shoulder girdle. In this case, “arthrosis” or “osteochondrosis” may gradually develop. Pain in the shoulders appears as a result of a tear in the rotator cuff, which requires surgical intervention on the tendons.
Beginning of rehabilitation
It is necessary to start with the fact that physiotherapeutic procedures begin the next day after surgery. It is very important to begin restoring the functions of the joint in time to fully resume its “work.”
Please note that for the first month or month and a half you will have to immobilize the limb. This is usually done either using a more "traditional" headscarf or using more modern methods.
In general, within 10-15 days, most operated patients experience restoration of the most necessary skills: putting on and taking off clothes, eating, hygiene procedures, simple housework, etc.
If we talk about the total rehabilitation period, it lasts from 3 months to six months.
Shoulder surgery
After this, a long recovery and rehabilitation after shoulder surgery is necessary. There are many programs and complexes of therapeutic exercises that can improve the healing of the shoulder girdle and accelerate the functionality and full performance of the upper extremities.
The human body is a complex and unique system with unlimited capabilities.
And even short-term immobilization of body parts will lead to disorder in general contracture. But at the same time, too active actions after surgery or an injury leads to an increase in the healing time of damaged tissues and the formation of additional problems during recovery.
In order to compensate for these completely different actions, rehabilitation after a dislocation or fracture of the shoulder joint is used.
Important! Sets of exercise therapy exercises to restore shoulder functionality should be prescribed by a specialist on an individual basis, who will determine the degree of load and timing of completion.
Doctors are forced to perform operations on the shoulder girdle when:
- Instability of the joint itself;
- Impingement syndrome;
- Fractures of the shoulder joint;
- Rotor cuff injuries.
Important facts about recovery after arthroplasty
- Physiotherapeutic procedures are prescribed only by a specialist!
- Therapeutic exercises must be performed up to 5 times a day for a month or more.
- For the first 6 weeks, serious stress on the joint is prohibited: stretching the arm back and to the sides, lifting objects heavier than a half-liter bottle of water, getting up from seats by leaning on them with a sore arm, driving a car, etc.
- After surgery, contact sports and any heavy lifting are prohibited.
Rehabilitation after shoulder arthroplasty in numbers and terms
- The need for inpatient treatment in the clinic - up to 5 days;
- Wearing a bandage to support the arm around the clock - for at least a month;
- Using a bandage to fix a limb at night - 2 weeks or more;
- Duration of incapacity for work is up to 6 weeks.
Please note that depending on the injured arm, the extent of the operation performed, the accuracy and precision of compliance with the instructions of the rehabilitation doctor, the period of incapacity for work may vary both less and more. Knowledge workers can return to work much earlier than those whose professions involve physical activity.
Therapeutic Physical Education (PT)
Rehabilitation during arthroscopy of the shoulder joint allows you to more quickly restore the functionality of the arm, although in this case the process may take six months.
The timing of exercise therapy depends on many factors:
- Size and extent of damage;
- The scope of the operated area;
- Duration of tissue regeneration period;
- Education or absence of complications;
- Age and general condition of the patient.
The use of exercises during sequential rehabilitation during joint treatment has the following advantages:
- Strengthening muscles and reducing their reflex overstrain;
- Restores strength and coordination of movements of the injured upper limb;
- A clearly distributed load allows you to quickly restore arm mobility after surgery on the shoulder girdle, without overloading it.
Rehabilitation after shoulder arthroscopy
The rehabilitation program is drawn up by a specialist, taking into account the characteristics of the injury, the type of operation and the nature of the expected loads. Recovery after arthroscopy takes place in several stages, with a consistent increase in the load on the joint and surrounding muscles, which leads to their strengthening and gradual healing.
Stage 1. Postoperative
1 – 4 weeks after surgery:
- Visiting a rehabilitation specialist from the first week after arthroscopy;
- reduction of swelling and pain in the operated shoulder;
- complete restoration of the range of passive movements in the joint;
- maintaining muscle tone that stabilizes the PS;
- stimulating blood circulation in the shoulder joint.
For the first few weeks after surgery, patients are advised to wear an orthotic bandage (shoulder brace) - the bandage fixes the operated arm in a semi-abducted position, reducing inflammation and preventing injury to the joint while performing basic household tasks. Restoring passive (under the influence of external force) mobility of the shoulder joint begins with performing simple exercises individually selected by a rehabilitation specialist:
- Static tension in the muscles of the shoulder girdle.
- Movements of the fingers, movements of the hand.
- Moderate flexion-extension movements in the elbow joint
- Dynamic exercises: raising the shoulder girdle, rotating and retracting the shoulder blades.
At first, when trying to perform any exercise, the shoulder muscles will reflexively tense, trying to prevent possible injury. This may result in slight discomfort and pulling sensations. A rehabilitation specialist will help you overcome reflexive fear and teach you how to perform exercises in such a way as to avoid re-injury.
In addition to physical therapy (physical therapy), rehabilitation after arthroscopy of the shoulder joint may include other procedures:
Mechanotherapy (device ARTHROMOT ACTIVE-K).
Exercises on a treatment device, which can be started within the first 24 hours after surgery under the supervision of a rehabilitation specialist. Work with the device is aimed at early painless restoration of mobility in the operated shoulder joint and strengthening of the stabilizer muscles. Has a positive effect on coordination of movements.
Neuromuscular electrical stimulation.
Electrical impulses are sent through the patient's skin, stimulating nerve endings to transmit signals to a specific muscle group. The muscles respond to the impulse by vibrating or contracting - just as during normal muscle activity, such as walking or working out in the gym. This allows you to optimize muscle strength and tone, and reduce pain.
Massotherapy.
The procedure reduces pain and swelling, improves blood flow to the operated limb.
Kinesiological taping.
Applying special elastic cotton tapes on an acrylic adhesive base to the skin around the joint. Tapes stabilize the joint and muscles, increasing their range of motion and providing an anti-edematous effect.
Manual and kinesiotherapy.
A set of exercise therapy methods aimed at maintaining the tone of the shoulder joint stabilizer muscles. For example, post-isometric muscle relaxation (PIR) techniques and proprioceptive neuromuscular facilitation (PNF therapy).
It will be useful to devote time to cardio training, for example, exercising on an exercise bike. However, at first, you should refrain from running - shaking while running can negatively affect the healing of the shoulder after arthroscopy.
Stage 2. Restorative
5 – 6 weeks after surgery:
- Visit a rehabilitation specialist once every 1-2 weeks;
- the beginning of restoration of active movements in the shoulder joint;
- restoration of muscle tone of the shoulder girdle;
- restoration of the sense of hand position in space (proprioception).
At the second stage, the rehabilitation specialist teaches the patient exercises aimed at restoring active movements - movements in the shoulder joint, carried out using the own muscles of the shoulder girdle. The pace, strength and amplitude of the exercises are selected so that they are comfortable and painless for the patient. Sharp, swinging, jerking movements are not allowed. Classes should be carried out 2-3 times a day, each exercise should be repeated 10-12 times. Examples of exercises:
- Rocking movements in the shoulder joint: lean forward and hang your relaxed arm. Swing your arm in different planes, avoiding positions that cause discomfort.
- “Sliding” the hand along a horizontal surface with a gradual increase in the range of motion.
- Household exercises (combing your hair, washing your face, etc.).
Exercises should be stopped if they cause swelling and/or increased pain in the joint.
Recommendations for recovery
Much attention should be paid to dosing the load and monitoring the dynamics daily. Each movement must be worked out as much as possible. Do not neglect ordinary actions, such as throwing a ball, hitting with a stick or bat, or swinging a tennis racket.
Temporary inoperability of the shoulder girdle quickly restores its functionality when the complex of rehabilitation gymnastics is supplemented with manual massage, physiotherapeutic procedures, and the use of specialized exercise equipment.
With all the actions taken together, you can very quickly return to the patient’s usual way of life.
Another way to carry out rehabilitation is stretching, which increases the elasticity of the tendons and allows you to quickly develop the damaged limb. All actions must be performed slowly, without sudden movements. Exercises are performed in an upright position of the body, legs slightly apart:
- One of the arms rises, bends at the elbow, moves to the area behind the back, and the fingers try to reach the opposite shoulder blade. Afterwards you should change limbs. Actions are repeated 4-5 times;
- Bend over while holding the back of the chair with your hands. When bending over, you need to pause and stay in this position for several seconds;
- Both limbs are brought behind the back. The arms are raised to the maximum possible height, after which they are lowered to the starting position. Should be repeated 4 times;
- To perform the exercise, use a towel, rope, or jump rope. Any of the accessories is taken by the ends, extended, and the arms are raised to the top, while moving back and not bending at the elbows, after which they are lowered at a slow pace.
Contraindications
It is not always possible to carry out physical therapy exercises during rehabilitation in full. At some points during training, the process of accelerating recovery itself can lead to aggravation of the existing problem.
You should resort to exercise therapy only if the following contraindications have not been identified:
- A feeling of severe pain in the shoulder girdle, which only intensifies with any movement;
- The presence of infectious diseases present during an exacerbation;
- A sharp increase in temperature caused by hyperthermia;
- Detection of a disease such as diabetes in a person;
- If the anamnesis shows the presence of a cardiac disease, because all the loads force the heart to work at a faster pace.
Rehabilitation for injuries to the shoulder part of the body is an indispensable condition for more quickly restoring the functionality and performance of the injured limb, allowing you to return to your normal lifestyle as soon as possible.