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.
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TOTALSHOULDER/HEMIARTHROPLASTY:140/40ACTIVEASSISTPROGRAM
PHASE2(6WKSTO12WKS):At6weeksprogressivestretchingisbeguntoachievefullmotionandencouragedaslongasitiscomfortable.Progressivesupinebenchisbeguntoregainforwardelevationstrength.Nointernalrotationagainstresistanceisallowedtopermitsubscapularishealing.
GOAL:Fullpainfreemotionoftheoperatedshoulderandabilitytoraisearmagainstgravitywhilestandingfullyupright.
Progressivesupinebench:Keyforregainingforwardelevationfunctionaftertheoperation.Inthefirstphase,thepatientliessupinewiththehandsclosetogetheronatowelorlightstick.Bothhandsarepresseduptowardtheceiling,finishingbyprotractionofthescapulaoffthetableasshownbelow.Inphasetwo,thehandsare
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progressivelyseparated,allowingthemtoactmoreindependently.Inphasethree,onehandpressesalone.Inphasefour,weightisaddedtothehandinsmallincrementsuntiltheweighttotals2pounds.Inphasefive,thebackofthetableorchairorrecliner,isprogressivelyraiseduntilthepatientisinthesittingposition.Eachphaseiscontinueduntil20repetitionscanbeperformedeasilybeforethepatientadvancestothenextphase
PROTRACTIONOFTHESCAPULAATENDOFEACHREPETITION