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      • 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 a 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.

      • Use soft collar for ____days, coming out for range of motion (without deep stretch) twice daily

      • Avoid Rotation and Extension (looking up) and side bending at the neck for 2 days.

      • Begin active stretching of scalene and trap by day 3 post injection

      • NO ACTIVE lifting with arms above shoulder height x 3 days; may do PASSIVE RANGE OF
        MOTION with shoulder and neck after day 2

      • Sleep with cervical neck support lying on your back as much as possible for 3-5 days.

      • f/u for PT in 4-7 days

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

      First 2 Weeks:

      • Strengthening/Motion: Isometrics and range of motion are good for muscles and pain control. PT will help with range of motion and home exercise plan.

      • Walking: No restrictions.

      • Cycling: May do a gentle ride on a stationary bike for 10-15 minutes without looking up, such as at a TV screen, 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 and strengthening of shoulder and thoracic spine

      • Cycling: No restrictions except would stay on an exercise bike until 4 weeks.
      • Swimming: May begin gentle kicking and pool walking.

      • Throwing/rock climbing/tennis: No rock climbing until after 6 weeks. Throwing can begin at 4 weeks 

      Weeks 4-6:

      • Strengthening/Motion: Progress to moderate loading and progressive strengthening. Work on maintaining or regaining the 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 a buoy for rest.

      • Throwing/rock climbing: Can begin some pre-climbing/throwing exercises with PT. Anticipate return to gentle climbing and return to the throwing program at 6 weeks.

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