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Shoulder Rehab Protocol


This section applies to all patients. 

  • No NSAIDS such as Advil, Motrin, ibuprofen, Naprosyn, and Aleve x 2 weeks

  • Pain: Tylenol for mild pain and if needed use mild narcotic provided.

  • Bracing: If recommended, use sling during sleep the first 2 nights if able. Sleep is more important so if you cannot sleep and use the sling, feel free to remove it.

  • Driving restrictions: No driving until you can safely shift and steer the vehicle.

  • Work restrictions: Depends on duration of lifting restrictions

  • Exercise restrictions: 2 weeks relative rest then 4 weeks progressive PT.

The following may not apply to all patients. Your provider will complete this section, depending on your needs.

☐ Use sling for ____days, coming out to flex and extend the elbow twice daily

☐ NO ACTIVE lifting above shoulder height x 1 week; may do PASSIVELY after day 3

☐ Do not actively rotate arm away from your body (keep hand between belly & your side) for 7 days and avoid sudden reaching out to side or behind you for 2 weeks.

☐ You can do simple pendulum exercises to help prevent a stiff shoulder

☐f/u for PT in 4-7 days

Activities: In general, with strength and activities, keep pain level below 4/10.

First 2 Weeks:

  • Strengthening/Motion: Isometrics are good for muscles and pain control. Gentle assisted and passive range of motion is good. PT will help with gentle range of motion.

  • Walking: No restrictions.

  • Cycling: May do gentle ride on stationary bike for 10-15 minutes, then 30 minutes after week 1.

  • Swimming: No swimming for the first 2 weeks.

  • Throwing/rock climbing/tennis: None of these the first 2 weeks.

Weeks 2-4:

  • Strengthening/Motion: Start gentle low load concentric/eccentrics with PT. Work on progressive motion using the other arm or stick.

  • Cycling: No restrictions except would stay on exercise bike until 4 weeks.

  • Swimming: May begin gentle kicking and pool walking.

  • Throwing/rock climbing/tennis: No throwing/rock climbing until after 6 weeks. May begin 10-15 minutes of ground strokes (noncompetitive) at 4 weeks.

Weeks 4-6:

  • Strengthening/Motion: Progress to moderate loading and progressive strengthening.

    Work on regaining full range of motion by 4-6 weeks.

  • Cycling: May do gentle road biking and trail biking; avoid mtn biking until 6 weeks.

  • Swimming: May try some gentle breaststroke for a few laps. Use buoy for rest.

  • Throwing/rock climbing: Can begin some pre-climbing/throwing exercises with PT.

  • Anticipate return to gentle climbing and return to throwing program at 6 weeks.