this section is to provide some
information about the initial post operative exercises the first exercise is the neck exercises
we do this to stretch out the neck typically because people will get pretty sore from wearing a sling for a
long period time especially up in these muscles or these muscles to do this turn to the left this is left rotation
lindsey will turn to the left twice this is right rotation turning to the
right two times like that and you have lateral flexion of the neck ear to shoulder twice like that this will especially stretch out these
muscles right rotation right lateral
flexion, sorry flexion of the neck lets bring the neck down twice like that an extension of the neck extending the
neck is simply looking up at the sky if you
have neck problems be sure to be aware so that you don’t create any pain with this exercise
if you do it’s not necessary to do it next exercise is the assisted elbow flexion grab the arm and assist your arm into elbow flexion this is elbow flexion typically the biceps will need to be
active to do this exercise to do this exercise actively simply take away the hand allow the arm to bend on its own again this will assist with the pumping
action that pulls the swelling out of the shoulder and
the arm and helps to keep the bicep muscles active the next exercise is hand wrist and elbow movements let’s have you hold your hand like this activity is allowed in the wrist and the
elbow to move the wrist going to extend the wrist point back flex it back and forth like that turning the wrist opening and closing the fingers as if you’re
making a fist and relaxing the next exercise is the ball squeeze you will be provided with a ball on your
ultra sling the purpose of the ball is to pump the arm muscles you hold this so that any edema or swelling that
comes down into the arm of the hand gets pumped out of the the upper extremity go ahead pump the ball there’s no limit to the amount of
repetition you do with this you can do this all day long if you like again it is to pump the swelling right back out of
the arm toward the heart next exercise is the pendulum to do this exercise properly let your arm hang and make small circles you’re going to
use your body weight to make the circles as not activate the rotator cuff muscles simply just sway forward and back oftentimes this exercise will help
with pain relief and is a nice warm up to the any of the
passive or active exercise you do as a part of your post operative
rehabilitation the next exercise the ankle pump the purpose of the ankle pump is to
prevent deep vein thrombosis that is a DVT DVT is a blood clot that may form in
your calf muscle it’s very dangerous because if you do
get a DVT it could become loose and create a pulmonary embolism which is a
blood clot that would go up to your lungs and it could be fatal so what we ask our patients to do as much as
possible is to place a thera-band around their foot hold with their uninvolved arm hold tight and lindsay lets just have you
pump your foot up and down by pumping the calf muscles you pump blood through the calf muscles and creative increased amount of
circulation as to keep blood clots from forming in the
calf muscles this exercise can also be done without
thera-band so lets have you pump and with an increased amount of walking
this will also help to increase circulation of the calf
muscles as well so this is also encouraged so lindsay let’s talk a little bit about
DVT prevention so we talked about that in the post op exercises we did your
ankle pumps that’s where you are moving your feet up and down either with or
without the thera-band and that’s going to put help promote circulation in your
lower extremities other things you’ll be provided with are a pair of T.E.D. hose
these are white stockings that you got right after surgery that you woke up with we’d like you to wear those for at least ten to
fourteen days and anytime you will be traveling in the car on an airplane for
long periods of time and of course we’re going to try to
start you on some type of cardiovascular exercise as soon as possible and that
will also help promote circulation whether it be walking or riding a
stationary bike you may not want to do anything to jarring in the beginning
because you just had shoulder surgery and those are things that will help
prevent deep vein thrombosis next exercise we will go over is
passive range of motion exercises passive range of motion means that
you’re not using your muscles as we do the motion for you the reason we have you do these
exercises to help increased range of motion move the joint so that the synovial
fluid circulates inside the joint thus promoting nourishment of the joint
and promoting circulation of the tissue surrounding the joint the next exercise is passive external rotation
to do this you have your patient lying on their back with a towel support under their arm external rotation is the motion where you
move the shoulder outward like this you see the humerus bone turns on an axis where you don’t abduct or elevate the
shoulder so it goes just like this we measure external rotation starting from here with the fingers pointing up
toward the sky at zero degrees this is zero degrees if
we move out externally just a bit this is thirty degrees this would be forty five sixty and ninety degrees of
external rotation while doing this exercise be sure that
your patient does not guard with their muscles contract their
muscles or have any major increases in pain while
doing the exercise as we move the shoulder to the inside this
can be considered internal rotation so internal rotation and external rotation
can be combined during this exercise an alternative to doing this exercise to
actually take the pillow away or the towel roll and sit next to the patient have their elbow right on your thigh you can place your hand on the shoulder
for support or keep it here and externally rotate and thats external rotation in a
passive range of motion the next exercise we will do is for elevation from here we can take the elbow hold
onto it firmly bring the arm into forward elevation again it’s important that the person
does not contract the muscles while during this exercise sometimes it’s helpful to have bend in
the elbow pull the arm close and maintain some contact with the
glenohumera joint just like this again if you feel that the person’s
contracting the muscle simply stop let them relax and then continue with the motion be careful when you’re lowering the
shoulder as lowering the shoulder is an anti
gravity motion when you lower a shoulder the person has a
tendency to contract the muscles when they do this they will probably create a bit of pain in the
shoulder so be sure that you’re slow with the lowering
motions and very supportive from this position we can go to
abduction lindsay i will have you hold onto my arm lindsay’s holding onto my forearm here i’m holding on to her elbow one hand here and we bring her arm into abduction like this this motion again is called abduction
abduction means to move away from the body dont help me too much be sure not to just let go of the arm hold on to it firmly position of support help your subject, patient, friend, spouse back into a comfortable resting position