Exercise Progression after Shoulder Surgery

If you have had shoulder surgery, you may benefit from the skilled services of a physical therapist to help improve your shoulder mobility and strength and decrease your pain.  Your PT will work with you to help you return to your optimal level of function and activity after your surgery.

Common types of shoulder surgeries that may require physical therapy include:

Each of these surgeries carries with it specific treatments and techniques to safely achieve the best outcome.  Some variables of a physical therapy program remain the same throughout; the basic goals during rehab after shoulder surgery are to safely improve range of motion (ROM), strength, and overall functional use of your arm.  Your physical therapist can help you achieve those goals.

Here is a list of some of the things that you may work on with your physical therapist after shoulder surgery.  The list starts with simple passive motions and progresses in difficulty and stress as you progress through your shoulder rehab.  Remember, this list does not replace the advice of your doctor or physical therapist.  You must check with your doctor before starting these, or any other, exercises after shoulder surgery.

Passive Shoulder Range of Motion Exercises

Shoulder pain can keep you from enjoying normal activities.
Shoulder surgery rehab requires a specific progression of exercises.. Pixlefit/Getty Images

In the initial days and weeks after your shoulder surgery, you should be able to start your rehabilitation with your physical therapist.  Your PT will show you how to don and doff your sling, and passive ROM exercises for your shoulder can be started.  Gentle pendulum exercises can be used to relax your shoulder muscles and keep your shoulder joint moving properly.

While wearing your sling, you may find that the muscles of your forearm and wrist or hand feel like they are getting weak. Your physical therapist may have your perform some putty squeeze exercises to keep your hand and forearm muscles working properly as your shoulder heals.

You may use a pulley system in the PT clinic to help improve your shoulder ROM through flexion, abduction, and internal rotation.  Using a pulley system at home may be necessary.  Your PT may be able to lend you a shoulder pulley, or you can make one yourself with some simple hardware store items.

Shoulder Isometric Exercises

Isometric exercises are exercises where no motion occurs while the muscles around your shoulder are contracting.  Isometric shoulder exercises are a great way to start to use your muscles again after shoulder surgery.

Even if you are still wearing your sling, you can perform shoulder isometrics to start engaging your rotator cuff muscles.  This can help prepare your shoulder muscles for increased workloads in the coming weeks of rehabilitation for your shoulder.

Active Range of Motion Exercises

Shoulder abduction active range of motion.
Start sidelying shoulder abduction by lying on one side with your shoulder and arm resting on your hip.. Brett Sears, PT, 2011

 Once you start achieving full or near full passive ROM in your shoulder, you physical therapist may have you start active ROM exercises.  These exercises are designed to get your shoulder and rotator cuff muscles contracting enough to move your arm and shoulder through its full range motion.

Don't be concerned if you initially find moving your arm difficult; your shoulder has been in a sling and has recently undergone the trauma of surgery.  Your rotator cuff and deltoid muscles have not been called into action recently, so they may not be able to fully raise your arm.  As you practice the active ROM exercises, you should find that your shoulder and arm function normally in a few short days.

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Scapular Stabilization Exercises

The prone
Lie face down and slowly raise your arm straight out to the side while pinching your shoulder blade back.. Brett Sears, 2011

Your shoulder is comprised of many different bones and joints.  These joints must work together to give you the ability to lift your arm overhead.  Your scapula, or shoulder blade, is the triangular shaped bone in the back part of your shoulder.

When you have pain or weakness in your shoulder after surgery, the muscles around your scapula may not function properly.  This causes improper shoulder and scapular motion that must be corrected.  

To overcome scapular muscle dysfunction, your physical therapist may have you begin scapular stabilization exercises.  These exercises are essential to help you regain normal mobility in your shoulder complex.

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Shoulder Rotator Cuff Strengthening Exercises

Photo of a man with drawn on muscles for arms.
Rotator cuff strengthening should be a part of your shoulder rehab.. Jessica Peterson/Getty Images

Once you have improved the passive and active ROM in your shoulder, it will be time to add a little resistance to your shoulder exercises.  You can use a resistance band, like a Theraband, to start rotator cuff strengthening.  Your physical therapist should be able to give you a resistance band.  Remember, the bands are color coded based on the amount of tension each band provides.

You can also use a small dumbbell to add resistance to your active range or motion exercises.  After surgery, it is important to start light and slowly increase the sets and repetitions of each exercise before adding additional weight to the exercise.  Your physical therapist will help you progress through your shoulder and rotator cuff strengthening program. 

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Overhead Throwing and Reaching Exercises

Photo of a baseball pitcher.
If you are a baseball player, you should learn the Thrower's 10 exercises.. Thomas Barwick/ Getty Images

 Once your shoulder has healed sufficiently after surgery and you are gaining good strength in your rotator cuff and scapular musculature, you may be ready to start performing more advanced overhead exercises.

The Thrower's 10 exercises are a group of exercises designed to improve the strength and mobility of your entire arm so you can prepare for more advanced overhead activities.

When returning to throwing activities, start out easy. Start with gentle soft toss, and progress your throwing gradually over a period of weeks. No need to get out there and start gunning it; start with simple throws over a short distance and gradually increase the number of throws your do and the distance between you and your throwing partner.

Remember, do not progress to advanced overhead throwing and strengthening activities until your doctor or physical therapist advises you to do so.

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Advanced Shoulder Plyometrics

Photo of a women exercising in quadruped.
Quadruped shoulder balance exercises may be done after a shoulder injury.. Stanton J. Stephens / Getty Images

When you think of jumping and bouncing that occurs in plyometric exercise, you typically think of the legs doing the work.  But you can also perform plyometric exercise for your arms and shoulders.

If you are an athlete or if you work in a job where you may have to quickly catch or throw something, then you may benefit from performing shoulder plyometric exercises.

Specific exercises like using the Bodyblade or using small weighted therapy balls can train your shoulders and arms to respond quickly whenever your need to catch or throw something.

If you have had shoulder surgery, you may benefit from physical therapy to help you progress through your rehabilitation.  By starting gently with passive ROM and progressing through active ROM and rotator cuff strengthening, you can be sure to safely and quickly get back to your normal activities.

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