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Orthopedic/Injury>>SHOULDER REPLACEMENT REHAB: A Patient’s Guide - 1/4/2007

I.                   INTRODUCTION:  Even though it is less commonly known than hip and knee replacements, shoulder replacements (arthroplasty) are just as successful in relieving joint pain.  This surgical procedure maybe recommended if arthritis or degenerative joint disease causes your shoulder to be painful and stiff which leads to impairment or limited use of the shoulder. 

II.                 TYPES: 

A.     Hemiarthroplasty:  is the most stable replacement and involves replacing the humeral head of the shoulder joint. 

B.    Total shoulder replacement: is a lot more unstable than a hemiarthroplasty and requires a more conservative rehab plan.

C.    Hemiarthroplasty for fracture to proximal humerus:  is the most fragile of shoulder replacements and requires a very conservative rehab plan.

 

 

III.              REHAB GOALS:  The goal of rehab is to restore the best possible function of the joint.  Following surgery, scar tissue will tend to limit movement.  Early motion of the total shoulder replacement helps achieve the best possible function.  After achieving functional range of motion, the goals progress to gradual strengthening and functional use of your shoulder.   The rehabilitation plan is designed to prevent stress on the repaired tendons (subscapularis) and to prevent dislocation of the shoulder joint.   

IV.             DO’s and DON’Ts:

v     Do wear your sling at night to protect your shoulder and to allow healing.  Typically, sling should be worn for one month.

v     Don’t use your arm to push yourself up in bed or from a chair because this requires a forceful contraction of the healing muscles.

                       

v     Don’t over do it!  You may experience a decrease in pain following surgery if your condition prior to the surgery was severe.  This may trick you into thinking that you can do more than you should.  Early overuse may result in severe limitations in motion.

 

v     Don’t lift anything greater than a cup of water for the 1st 6 weeks following surgery.

 

v     Do not force passive stretching especially into shoulder external rotation.  Initially limit external rotation to neutral only.

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