Rehab Protocol: Reverse Shoulder Arthroplasty

First 2 weeks

• Reduce pain and inflammation:
  • Use your pain killers +/- anti-inflammatory medication as prescribed.
  • Ice packs can be applied during the first few days for 20 minutes at a time, but don’t let the dressing get wet.
  • You may be more comfortable sleeping in a slightly inclined position, such as a recliner.
• Protect the surgical scar:
  • The surgical scar needs to be protected for 3 weeks. Keep your dressing as dry as possible and only have the dressing changed by a nurse or doctor if it becomes completely soiled from the scar itself or accidentally soaked by water. To reduce the chances of getting a wound infection, it will be best to keep the original dressing on until your 2-week follow-up visit.
  • Please contact Dr Grey if you have concerns regarding the dressing, or if you develop worsening pain and/or redness around the dressing.
• The sling:
  • Keep the arm in the sling with the belt around the waist for the first 4 weeks. You also need to sleep with the sling on. The sling should be opened a few times per day to allow the elbow to straighten. It can be removed when changing clothes or going for a shower, but try to keep the operated shoulder relaxed. Do not try to lift your arm up by yourself yet. To wash your armpit, bend forward while keeping your arm and shoulder relaxed. Gravity will cause your arm to go away from your body, allowing easy access to your armpit.
• Exercises:
  • Commence hand, wrist and elbow exercises.
  • Neck stretching exercises
  • Gentle pendulum movement: Lean forward and allow gravity to take the arm away from your body.

2 – 6 weeks

• The first post-operative visit is at 2 weeks. The scar will be inspected, and the dressing changed.
• Continue with the sling. It can gradually be weaned between 4 and 6 weeks.
• Start pendulum exercises: Bend forward and allow the arm to hang down completely relaxed. Gently move it forwards and backwards, side to side, and make circular movements with the arm.
• You can perform activities of daily living below shoulder level, but avoid lifting anything heavy and pushing yourself up with the operated arm.
• Commence physiotherapy: Physio guidelines:
  • Gentle passive range of motion, limiting forward elevation to 120’.
  • Limit passive external rotation to neutral if the subscapularis was repaired during surgery.
  • Avoid extension beyond neutral.
  • Active assisted range of motion with the same precautions.
• The next post-op visit is at 6 weeks.

After 6 weeks

• The sling should be completely weaned by now.
• Continue physiotherapy and stretching exercises.
• Progress to the active range of motion (lifting your arm without assistance)
• You can start lifting lightweight objects.
• Start driving at around 8 weeks, as long as you feel in control of the car.