Reverse Shoulder Replacement Rehabilitation

Therapist Information

  • This operation is indicted for patients who have no rotator cuff as well as arthritis. Conventional rotator cuff strengthing exercises will not work.
  • The shoulder function is dependant on the action of anterior deltoid and this is the key to rehabilitation.
  • The Subscapularis Muscle may have been detached (if present) and re-attached as part of the operation. This is why the range of motion in external rotation may be limited for a time.
  • With this limit it is still important to start to move the shoulder as soon as possible as pain allows.
  • Many of the muscles will not have been used for some time due to pain and stiffness. Rehabilitation may therefore be slow.
  • Please check the operation note for full details of the procedure performed.

 

Before Discharge

Day 1:

  • Vacuum drain removed from wound.
  • There will be a dissolving stitch in the wound with paper stitches and a dressing over the top.This may be changed.
  • You may shower with the dressings on but do not immerse the wound in water for 2 weeks. The paper stitches will peel off easily. No stitches need to be removed.
  • Start gentle exercises to prevent elbow and wrist from becoming stiff.

 

Day 2 (approx):

  • Xrays to confirm implant position
  • Start exercises for the shoulder
  • No Active Internal Rotation
  • External Rotation to the limit set in the Operation Note only
Figure 1 Figure 2 Figure 3 

 

 

Day 3-5

  • Start Isometric Cuff strengthening if indicated in the operation note (depends on the quality of any remaining cuff). No internal rotation

 

Figure 1 Figure 2  Figure 4

 

 

Discharge: When comfortable. This is usually 3-6 days.

 

Discharge to 3 weeks

  • Start Passive Abduction Exercises
  • Start External Rotation to neutral
  • Start Active assisted flexion in supine progressing to sitting if possible

 

3-6 Weeks

  • Outpatients appointemnt at 3 weeks to check the wound.
  • Formal physiotherapy usually starts at 4 weeks
  • Start to work on all range including Internal and External Rotation
  • If pain allows and range is good then progress to strengtheing this will involve the AINSWORTH PROGRAMME

 

 

Late Stage

Continue to work on range and strengthen as tolerated

Progress is very individual and will depend on a number of preoperative factors incuding

  • The severity of the arthritis
  • The condition of the muscles
  • The stiffness of the joint

 

Improvement can be seen for up to 18 months following surgery