- You just had shoulder surgery
and now you're anxious to get back to the activities
that you did before the surgery.
I'm Marty Kelly with Penn Rehab,
and I'm going to show you exercises that you'll do
during the first phase of rehabilitation.
The first exercise I'm going to show you
can be done in a lying down position
or it could be done standing or sitting in the sling.
But we're going to go ahead
and get Bryson out of the sling here
to get ready for some other exercises he's going to do.
The arm is going to be rested. You're going to do fist pumps.
Make a fist, hold 3 seconds.
Open it up. And why are you doing this?
This is to help maintain strength in the forearm muscles
but really, more importantly,
you're trying to use these muscles as a pump
to move fluid out of them.
The issue is whenever your arm is at the side
for long periods of time,
you tend to accumulate fluid in the forearm and hand.
So this will help to move that fluid out.
Three seconds, squeeze, open up, hold for 3 seconds,
doing that 10 to 20 times.
You can do that 10 times a day.
The next exercise is going to be
with the arm kind of at the side,
protected on the pillow.
Let me have you straighten the elbow
and bring that on down
and then bend the elbow up all the way.
So being in a sling all day long,
you can straighten that back out,
your elbow can get stiff.
So we want you to do some elbow exercises
to make sure you maintain motion at the elbow.
This also can help with fluid accumulation,
but just working the elbow into a straight position,
holding for a few seconds, bending the elbow fully,
holding for a few seconds, doing that 10 to 15 times,
doing that 3 to 5 times a day.
The next exercise is really an important exercise to do.
This is to prevent excessive stiffness at the shoulder
but absolutely to protect the surgical area
whether you've had a rotator cuff repair done
or total shoulder arthroplasty
or a SLAP lesion or a Bankart repair.
All of them pretty much are done in this position
when within a 30-degree range,
and I'll talk more about that 30 degrees in a little bit.
What you're going to use to do this
is some type of rod device.
You can use a golf club, you can use an umbrella,
you can use a broomstick.
You can go out to the hardware store
and get PVC pipe and put little T's on the end of it.
The point is that you're going to place
whatever you choose to use into the hand
on the surgical side,
and then grab it with the other hand.
I would recommend that the other arm
is supported by the pillow.
This hand, the nonsurgical hand,
is going to be down towards the waist.
Your surgical arm is going to be up on a pillow
about 6 to 8 inches from the side of your body,
and the elbow is going to be at a right angle
or a 90-degree angle, so just in this position.
When we start the exercise,
consider this position as being our zero position.
This is where you're going to start from,
and you're going to use the other arm.
Try to relax your surgical side
and you're going to gently with the other arm,
this surgical side is totally relaxed,
you're going to push out until you move 6 to 8 inches
out to the side or what is considered a 30-degree angle,
and that will be seen on one particular view here.
You're going to hold that for about 10 seconds.
You're going to bring it back in to the start position
which is about zero or kind of where the forearm is vertical
and you will repeat that 10 to 15 times.
Again, that will be dependent upon
who is instructing you in those early exercises.
But typically, you're going to hold
for 10 seconds, doing that 10 times.
The next exercise we're going to do is forward elevation,
and it's a passive exercise
meaning that your other arm does all the work.
So I'm going to have Bryson grab his wrist
on the surgical side,
and he's going to totally relax his surgical arm
which in this case is the left side
and use his right arm
to bring his left arm over the head.
You're going to think about your hands
passing over your face
and bringing it up to the point that you can.
Now, you're going to be-- have some discomfort
when you do this exercise.
So take it to the point where you feel some discomfort.
You're going to hold for 10 to 15 seconds.
So we'd like to start maybe at 10 seconds
and over time we'll increase that hold time to 15 seconds.
Again, totally relaxing the surgical side,
you then use the other side
to bring it back down onto a doubled-up pillow.
It's very important you start from a doubled-up pillow.
If you don't use the pillow,
the arm falls down to the surface,
and that will create a great deal of discomfort
and actually can cause some tension on the repair site.
So you'd be doing this 10 times, holding 10 to 15 seconds
and you're going to be doing this 3 times a day.
The next exercise is the pendulum.
This is a nice warm-up exercise that you would do standing.
You're going to be in the sling.
You come out of the sling like we've seen before,
just leaning over.
You're going to use your kitchen table to help support you,
one leg behind the other.
The arm is just dangling,
and Bryson is just going to make some circles.
So he's really not using the muscles of the shoulder.
He's just kind of, very gently
letting his arm swing in circles,
and you can swing that about 20 times say clockwise
or counterclockwise, and then after 20,
you just reverse, go the opposite direction.
You would lean over to the point where you feel comfortable.
If this were uncomfortable, if you stood up a little bit,
you might do the pendulum from there.
If you could lean over more,
then you would do it from that position.
The next exercise I'm going to show you
is what we call chair stretch, and this is an alternative
to the exercise we just did lying down,
the forward elevation stretch because the one lying down
can be quite uncomfortable in the early postoperative phases.
This is actually an easier stretch
and it does the same thing
which is to maintain forward elevation motion.
So Bryson is going to go ahead and kind of slip his arm
out of the sling.
He's going to lean over as he does that.
He's going to take his other hand
and place that hand on the chair.
Now you could do this, and go ahead,
support yourself on the table.
So at home you might do this at your kitchen table,
place a chair in this orientation.
You now will begin to step away, and as you step away,
let's stop right about there, you're going to lean forward.
And that's probably about how far you may get
before you feel discomfort.
Again, the idea is you get to the point,
you feel some discomfort.
You hold that position for 10 to 15 seconds
and then you would walk back up.
All right. Stand up so that you're not getting back pain.
Repeat the process, okay.
If you can get further back, then do so.
I'm going to have you do it one more time.
So hand is on the table to support your body weight.
Put one leg behind you and then lean over.
The weight is moving away.
You're not pushing into this hand, all right.
The weight is moving away.
Get to the point where you can get good elevation.
The angle between your arm and your body is increased.
Ten, 15 seconds.
Repeat that 10 times, doing that 3 times a day.
These exercises will guide you
through the first six weeks of your rehabilitation,
and they're really critical to maintaining motion,
yet at the same time, protecting tissue.
Once you're through this first six weeks safely,
we're going to move on to exercises
that include active-assistive range of motion,
active range of motion, and resistive exercise,
and we're going to show you that in the next video.