Q: I have just had surgery for to repair a rotator cuff tear. Will I need therapy?
A: Therapy is typically ordered by your orthopedic surgeon to complete your rehabilitation. Moving the area in very specific ways - a protocol designed for a specific surgical procedure - is prescribed. A therapist - physical or occupational - is highly trained to administer the proper stretches - gently - that will help to regain movement and full function to your shoulder.
Following shoulder stabilization surgery, your arm will be placed in a sling, usually for four to six weeks. Right after surgery, your shoulder will be painful and stiff, and it might swell. You will be given pain medication to help control your pain; icing your shoulder will help reduce both the pain and the swelling.
Your physical therapist will guide you through your postsurgical rehabilitation, which will progress from gentle range-of-motion and strengthening exercises and ultimately to activity - or sport-specific exercises. The timeline for your recovery will vary depending on the surgical procedure and your general state of health, but full return to sports, heavy lifting, and other strenuous activities might not begin until four months after surgery. Your shoulder will be very susceptible to reinjury, so it is extremely important to follow the postoperative instructions provided by your surgeon and therapist.
Physical therapy after your shoulder surgery is essential to restore your shoulder's function. Your rehabilitation typically will be divided into four phases:
Phase I (maximal protection). This phase lasts for the first few weeks after your surgery, when your shoulder is at the greatest risk of reinjury. Your arm will be in a sling, and you likely will need assistance or some special strategies to accomplish everyday tasks such as bathing and dressing. Your physical therapist will teach you gentle range-of-motion and strengthening exercises, will provide hands-on techniques such as gentle massage, will offer advice on how you can reduce your pain, and might use cold compression or electrical stimulation to relieve pain.
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Phase II (moderate protection). This phase typically begins one month following surgery, with the goal of restoring mobility to the shoulder. You will reduce the use of your sling, and your range-of-motion and strengthening exercises will become more challenging. Your therapist will add exercises to strengthen the "core" muscles of your trunk and shoulder blade (scapula) and "rotator cuff" muscles - those are the muscles that provide additional support and stability to your shoulder. You will be able to begin using your arm for daily activities, but you'll still avoid any heavy lifting with your arm. Your therapist may use special joint mobilization techniques during this phase to help restore your shoulder's range of motion.
Phase III (return to activity). This phase will typically begin about three months after surgery, with the goal of restoring your strength and joint awareness to equal that of your other shoulder. At this point, you should have full use of your arm for daily activities, but you will still be unable to participate in activities such as sports, yard work or physically strenuous work-related tasks. Your physical therapist will increase the difficulty of your exercises by adding more weight or by having you use more challenging movement patterns. You might be able to start a modified weight-lifting or gym-based program during this phase.
Phase IV (return to occupation/sport). This phase will typically begin four months after surgery with the goal of helping you return to sports, work and other higher-level activities. Your physical therapist will instruct you in activity-specific exercises to meet your needs. For certain athletes, this may include throwing and catching drills. For others, it may include practice in lifting heavier items onto shelves or instruction in raking, shoveling, or housework. Your therapist also might recommend a shoulder brace to allow you to gradually and safely return to your activity level without reinjury.
Q: I am a 55-year-old woman who woke up one day and discovered that my shoulder doesn't work correctly. I cannot lift my arm over my head and I don't know what to do. My friend said she experienced something called "frozen shoulder." Should I seek help from a therapist?
A: Yes, we would suggest a free consultation. This is a 10-15 minute meeting with a therapist designed to give insight into the underlying cause of the issue. If the therapist feels they can help, a report is sent to your physican explaining the reasons for a request for a prescription for therapy. We urge patients to not wait as therapy is very helpful in regaining full function.
Source: moveforwardpt.com. Chautauqua Physical & Occupational Therapy is celebrating 17 years of serving our community. We are located in the Riverwalk Center, are therapist owned and are the only outpatient clinic in the area to offer free consultations. Call us at 488-2322 or visit www.chautauquapt.com.