After a shoulder replacement operation, its important to do exercises to strengthen your shoulder and arm and promote recovery. Find out more.
Try these approved at-home workout moves for better joint health if you have osteoarthritis.
Torn shoulder labrum is painful and restricts motion. Do these 8 shoulder labral tear exercises to heal your shoulders and recover fast. Take a look!
After a reverse shoulder replacement: you may wonder if there are any permanent or temporary restricted movements ans limitations?
If you're new to working with patients post shoulder replacement, be sure to check out our comprehensive guide on everything to know here.
How to release a pinched nerve in the shoulder: It doesn't take long to alleviate the radiating numbness that often ensues with pinched nerves and neck/shoulder
The reverse total shoulder offers a treatment option for a problem that previously had none: the unstable, cuff deficient shoulder. There ar...
Here are 5 of the most common strengthening exercises we prescribe to help you achieve the best reverse shoulder replacement recovery.
Does the prospect of even merely moving your shoulder seem painful and terrifying? Have you ever tried physical therapy exercises for shoulder pain? Here is all you need to know
The reverse total shoulder offers a treatment option for a problem that previously had none: the unstable, cuff deficient shoulder. There are now substantial reports of the use of this type of prosthesis to manage a wide range of pathologies, including rotator cuff deficiency without arthritis (see example below in which pseudoparalysis after an attempted tuberosity and cuff repair was treated with a reverse total shoulder) rotator cuff tear arthropathy, rheumatoid arthritis, failed anatomic arthroplasties, arthritis with glenoid bone deficiency, fractures and post traumatic arthritis (as shown in the example below - not that cement was required because the humeral shaft did not allow a secure press fit) There are several important failure modes after reverse total shoulder. Infection is one of the more common and is probably related to the fact that many reverse total shoulders are performed as revisions after multiple prior surgeries coupled with the dead space created when the humerus is displaced distally by the procedure. As with anatomic shoulders, Propionibacterium is a frequently cultured organism from failed reverse total shoulders, which can present with loosening in the absence of the usual clinical signs of infection The infection with Propionibacterium in the x-ray on the left was treated with a single stage exchange to a long stem prosthesis. The patient is currently asymptomatic six years after the revision. Instability can result from falls, suboptimal component selection, component malposition, bulky tissues in the posterior shoulder, leverage of the humeral component against the glenoid , or lack of sufficient compressive effect by the deltoid. Early closed reduction can be successful. Recurrent or chronic instability may require surgical revision. The case below shows a failed anatomic prosthesis for fracture with anterosuperior escape that was treated with a reverse that dislocated recurrently. The prosthesis was revised to a hemiarthroplasty that was unsatisfactory. Finally a successful revision was accomplished by the removal of posterior scar tissue and revision to a reverse with a 40 mm set of components. Shown below is another example where stability was restored by changing to a larger diameter of curvature and increasing the thickness of the polyethylene and humeral cup. The risk of humeral fracture is increased in revision surgery, by falls and when the humeral component fixation results in an abrupt transition between a cemented or press fit diaphyseal stem tip and osteopenic bone distal to the prosthetic tip These fractures deserve a trial at closed management. in that surgical revision can be very complex Scapular and acromial fractures can result from excessive deltoid tension producing a fatigue fracture or from bone weakened by screw placement. These fractures are preferably treated non-operatively. Scapular notching is a prominent complication, particularly common in prosthetic designs that medialize the humerus or when the glenoid component is positioned high on the glenoid bone. The issues with notching are not so much the ‘notch’ in the scapula but the radiographically unseen damage to the polyethylene of the humeral component and to glenoid component fixation Notching may also be associated with unwanted bone formation that limits the range of motion Humeral component failure may result from dissociation of the cup from the stem Glenoid failure may result from glenosphere-baseplate dissociation, glenoid fracture, or failure of fixation While some cases can be reconstructed, others require salvage conversion to a hemiarthroplasty after glenoid component removal; the clinical results of this conversion are generally poor. Neurologic lesions can result from dissection, retraction or over lengthening of the arm. Finally, there has been some concern about loss of active external rotation with reverse total designs that medialize the tuberosity, prompting consideration of latissimus dorsi transfers; this problem seems less of an issue with those designs that maintain ‘East-West” tensioning of the residual cuff posteriorly. You can follow this blog by clicking the blue "follow" button at the upper right side of this page. You can support cutting edge shoulder research that is leading to better care for patients with shoulder problems, click on this link. Here are some videos that are of shoulder interest Shoulder arthritis - what you need to know (see this link). How to x-ray the shoulder (see this link). The ream and run procedure (see this link). The total shoulder arthroplasty (see this link). The cuff tear arthropathy arthroplasty (see this link). The reverse total shoulder arthroplasty (see this link). The smooth and move procedure for irreparable rotator cuff tears (see this link). Shoulder rehabilitation exercises (see this link).
These rotator cuff strengthening exercises will build strong, stable and mobile shoulders – helping you stay active and pain-free.
Looking for exercises to avoid shoulder replacement surgery? The #1 most effective exercise to avoid shoulder replacement surgery is.........
After a reverse shoulder replacement: you may wonder if there are any permanent or temporary restricted movements ans limitations?
Does the prospect of even merely moving your shoulder seem painful and terrifying? Have you ever tried physical therapy exercises for shoulder pain? Here is all you need to know
SAN DIEGO, Calif., March 14, 2017 /PRNewswire-USNewswire/ -- A new study being presented today at the 2017 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS), found that 96.4 percen
EXERCISES FOR RANGE OF MOTION AND STRENGTHENING OF SHOULDER Basic, Passive, And Active-Assisted Range-Of-Motion Exercises The rehabilitation exercises shown in this section are applicable to both nonoperative and postoperative treatment for all of the shoulder conditions discussed in this book. The specific exercises used, their progression, and their coordination with other treatment modalities are specific to the diagnosis, the severity of the pathologic process, and many other patient and surgical factors. A detailed discussion for each of these conditions is beyond the scope of this book. In general principles, the exercise program should start with the easiest exercises to perform and can be progressed when the early phase exercises can be done easily and with comfort. The first priority in rehabilitation of the shoulder is pain management and to avoid injury during the exercises. Pain management may include one or more of the following: application of ice or heat; use of nonsteroidal anti-inflammatory agents, narcotic medication, corticosteroid injections, or bracing; nerve blocks; or surgery. The first priority is to regain most of the passive range of motion before concentrating on strengthening. Strengthening should include both the shoulder and scapula as well as the trunk musculature. Strengthening of the scapula should begin at the time to start phase I strengthening of the glenohumeral musculature. Scapula-strengthening exercises include shoulder shrugs and rowing-type exercises (shoulder protraction and retraction). Coordination of scapula strengthening with glenohumeral strengthening is necessary for successful progression to the overhead exercises of phase II. In general, the progression of strengthening of the glenohumeral muscles should be first strengthening the rotator cuff in nonimpingement arcs of motion (phase I) to obtain good strength in rotation by the side as well as good scapula strength before beginning active elevation strengthening. Before starting resisted elevation with weights the patient should have full active elevation without a weight. If this is not achieved, continue phase I strengthening and scapula strengthening and add gatching and closed-chain active elevation strengthening. When full active elevation is achieved without resistance, then the patient can start phase II strengthening. Most effective rehabilitation programs require a daily home-based effort by the patient. In most circumstances the exercises should spread out over the day and not be concentrated into an intense once-a-day regimen. This basic principle of early shoulder rehabilitation is particularly important in the early or acute stages of rehabilitation when the shoulder is at its worst with respect to pain, motion, or strength. The worse the problems, the more frequent the exercises should be performed, but with short periods of exercise done well within the patient’s abilities. The initial program should focus on the most key and deficient problems for that diagnosis. For example, the primary problem with early severe frozen shoulder is pain and loss of passive range of motion. This should result in the need to achieve effective pharmacologic pain management and to focus on passive range-of-motion exercises to achieve improvements in passive range of motion and improvement in pain before considering adding strengthening exercises to the program. The more painful the shoulder, the more gentle the exercises, which are done for a shorter duration but frequently during the day. As the shoulder improves, the exercise periods can be more consolidated for longer duration and then progressed with respect to intensity. Patient education and participation is critical to success for either nonoperative rehabilitation or post-operative rehabilitation. Clear and precise communication between the physician and patient and therapist is as important to a successful outcome as is the precision and expertise by which all of the other treatment is performed, including surgery. Pendulum exercises are performed with the patient leaning forward with the arm supported on a stable structure such as a table and the waist bent at approximately 90 degrees. The affected extremity is allowed to dangle in front of the patient’s body, and small circular motions are made either clockwise or counterclockwise, allowing for general passive range of motion of the glenohumeral joint. Supine passive forward elevation is done in the supine position using the unaffected extremity as a means to move the affected arm passively or with active-assisted elevation (some muscle activity of the affected shoulder). This is generally done in the plane of the scapula. The plane of the scapula is midway between the true coronal plane (parallel to the plane of the body [pure abduction] and the sagittal plane, which is perpendicular to the plane of the body [pure forward flexion]). The plane of the scapula lies 30 to 40 degrees anterior to the coronal plane. The plane of the scapula for motion exercises places the rotator cuff and other muscles of the shoulder in the most physiologic and natural position with respect to the scapula body. For all passive exercises, when the arm reaches its maximum level of gentle passive arc, there is a gentle stretch given to increase the arc of motion. Repetitive movements are done during one session a few times each day. Active-assisted forward flexion can also be done using an assistive device such as an exercise wand in the standing position. Passive external rotation is done using a device such as a cane or exercise wand. Cross-body adduction stretches the posterior capsule, and normal posterior capsule length is important to achieve full forward elevation or full internal rotation. Basic Shoulder-Strengthening Exercises Progressive resistant strengthening exercises can be performed in phases. Phase I involves the use of an elastic band for external rotation with the arm by its side to avoid impingement or overstressing of the rotator cuff tendons. The concept of progression of strengthening from phase I to phase II is to first strengthen the rotator cuff by doing rotational exercises in the least difficult or pain-provocative arm and body position. After achievement of better rotator cuff strength and shoulder function with the phase I exercises performed with the arm by the side, then the shoulder should be better able to tolerate the more difficult exercises for phase II strengthening. Phase I strengthening can be done either using both hands with the elastic band or with the elastic band to a stationary object such as a doorknob with a pillow under the arm to provide slight abduction and then external rotation away from the body. It is best to use a stationary object so that the better or stronger shoulder does not overpower the weaker shoulder. Internal rotation can likewise be performed with the arm in slight abduction and internal rotation toward the abdomen. Extension is performed in a similar matter with the elbow by the side pulling the band. Forward flexion is shown with the elastic band with the arm moving in the forward position generally below shoulder level. Many of these same exercises can be performed with alternative techniques using a handheld 1- to 5-lb weight. For patients with severe weakness of forward elevation, graduated exercises are performed starting initially in the supine position without a weighted extremity. The arm is actively elevated with the patient in the supine position. When this can be easily achieved with multiple repetitions, a small 1-to 2-lb handheld weight is utilized again until this can be done easily and repetitively. When this is accomplished, the patient is then elevated with the torso at 30 to 40 degrees without a weighted extremity. This is again tested repetitively until this can be done with ease, after which a small 1-to 2-lb hand-held weight is added. This is repetitively accomplished until the patient is able to g adually bring the arm up actively in a seated position. An alternative way to graduate to the full active elevation without assistance is the use of closed-chain activeassistance strengthening in forward flexion. This can be done with an exercise wand or preferably by a lightweight exercise ball. The patient places both arms on the ball and with assistance squeezes the ball and raises the arm above the head. The weak side is on the upper portion of the ball and is assisted by the strong arm, which is on the lower part of the ball. As the weak shoulder becomes stronger, the patient moves his or her hands to an equal and opposite side of the ball and when very strong can use the affected arm on the underside of the ball as an assistant to the normal side. These exercises are useful as an intermediate step to achieve full active elevation and progressive resistive exercises and forward flexion above shoulder level.
The reverse total shoulder offers a treatment option for a problem that previously had none: the unstable, cuff deficient shoulder. There ar...
Graphic for the Health section describing which and how joints are replaced as well as their estimated duration. Illustrator, Lightwave 3d and Photoshop.
A reverse total shoulder replacement is similar to a regular total should replacement, but instead has the ball portion of the replacement attached to the humerus.
Shoulder surgeries are major medical procedures that typically lead to pain, swelling and significantly reduced mobility while the body heals over the course of a few months. Regardless of the type of shoulder operation — rotator cuff...
Tight or stiff shoulder can cause you a great deal of discomfort. In fact in some cases, it can greatly interfere with your mobility. In most cases, shoulder
A biceps tenodesis repairs a tear in the tendon that connects the biceps muscle to the shoulder. Here’s how to know if this procedure will ease your pain.
Shoulder pain causes and treatment with exercises based on your symptoms. I'll explain the cause of your symptoms and the right exercises
After a reverse shoulder replacement: you may wonder if there are any permanent or temporary restricted movements ans limitations?
Fetal position is super-comfy... until you wake up in pain.
General Considerations: Use of a sling for 3 weeks post-op unless otherwise indicated. No pulley in the first 6 weeks. No resistance until 4 ½ months, periscapular strengthening ok. Minimize heavy, excessive cyclic loads for the first 6 months. Maintenance of good postural positioning when performing all exercises. Maintain surgical motion early, but protect subscapularis repair by avoiding internal rotation strengthening for the first 4 months. Aerobic conditioning throughout the rehabilitation process with pool a
See this new post regarding stretching ( link ), it provides additional figures and videos of the key exercises. Stretching exercises are ...
Are you in search of physical therapy exercises for shoulder pain? Uncover six scientifically tested exercises and... Alternative solutions!
A torn rotator cuff can heal provided the injured person seeks medical attention immediately. If you ignore the injury, treatment options will be more serious and complicated
Shoulder Pain and Rhomboid Trigger Points Trigger points are common in all the main shoulder and neck muscles In fact just about all of us have latent trigger points, usually as a result of poor posture .... one of those simple things that they used to teach in schools but has long ago vanished. Failure to work on
Ever feel that nasty pinch in your shoulder when you go to lift your arm up toward the ceiling? This is what we call a shoulder impingement and I’ve been there so I know it’s not a fun feeling. In today’s coaching I’ll show you the simplest most effective way to clean up your shoulder problem in no time.
Are you a candidate for a total knee replacement? If so, I hope this article, which includes my husband's joint replacement, will benefit you. Hip and shoulder replacement candidates can also benefit.
