(light rock music)
- Following a labral repair,
the patient will come in generally
the next day after surgery,
and we will see them in physical therapy.
The first visit will be about removing the bandages,
educating the patient on what the postoperative care
is going to be all about.
The physical therapy goals after labral repair
include initially decrease pain,
to increase passive range of motion.
We then move on to increasing active range of motion,
progressing with strength.
Then moving on to return to normal function
and functional activities.
The initial phase is generally four to six weeks.
That depends on the nature of the surgery.
All labral tears are not the same.
It depends on the type of the tear
and how bad it was.
The doctor will give us information on the first visit,
so that we are aware of how bad the tear is,
and that will guide us as to how quickly
or how slowly we can progress with the rehab.
Some of the common exercise in the first phase are passive.
They would include things like a pendulum exercise,
a table slide, postural re-education exercises
such as posterior shoulder rolls.
We may use a ball or another device
to help you to move your arm
without actually using your shoulder muscles
to create the motion.
We call it active assisted range of motion.
That's generally allowed around two weeks.
After the patient is allowed to be out of the sling,
we work on active range of motion.
That would include just general activities
such as dressing, combing your hair,
putting dishes away in the cupboard.
But the emphasis is on proper mechanics,
being able to do it without shoulder compensation,
without cheating, elevating your shoulders,
making sure that the shoulders are in a good posture
so that the mechanics are normal,
so as not to put abnormal stresses on tissues
or create inflammation or irritation where it shouldn't be.
As the active motion progresses
and mechanics are good and the patient
is able to do the lower level activities
without pain and with good mechanics,
then we would progress to more of a strengthening phase
where you would be perhaps lifting some weights
or resuming your normal activities.
A home exercise program is important
through all three phases of the rehab.
Initially on the first day you'll be given homework
which includes passive range of motion.
We generally start based on the patient's ability
and what they're able to show us on the first visit.
Then that program will build with each visit.
Generally in the first few weeks it's very similar.
As you progress, the program becomes
a little more difficult.
We take the easier exercises away
and add more advanced exercises
based on your progress and what our goals are
in terms of your recovery.
The overall time for the recovery phase and the rehab
is anywhere from two months to four months,
depending on what the state of the shoulder was
coming into therapy, and what the desired
end result will be, whether it be
a higher level activity.
Of if there are not a lot of demands
on the shoulder afterwards it may be less time.
It also depends upon how much motion
the patient had in the shoulder prior to the surgery,
and how successful we have been
to gain range of motion early on,
and how long it takes us to regain
the full amount of motion that we need to be successful.
- After a labral repair, it's important
to let your physical therapist,
along with your doctor,
guide you through the rehab process.
After a labral repair,
you won't experience the same pain
you had prior to surgery.
Having less pain makes you think it's okay
to start moving your arm right away.
But be careful.
The absence of significant pain can trick you
into thinking your shoulder is healed,
but this is misleading.
You may no longer have pain,
but it still takes many weeks
for the tissues in your shoulder to fully heal.
While your labrum heals, your physical therapist
passively keeps your shoulder stretched and mobile.
You'll gradually be introduced
to more complex exercises,
helping you regain normal function of your shoulder.
These exercises will focus on improving
the strength and control of your rotator cuff muscles.
They help tighten the ball of the humerus
in the glenoid socket,
improving the stability of your shoulder.
A stronger, more stable shoulder
keeps the ball of your humerus centered in your socket
during all your activities.
At Coordinated Health, we work as a team
in your diagnosis and treatment,
but you're the key member of that team.
Maintaining a stable, pain-free shoulder
means working hard to understand and perform
the exercises we teach you.
Stretching and strengthening your shoulder on a daily basis
allows you to better perform all your activities
with a pain-free shoulder.
And that's the art of medicine.
(light rock music)