Post Procedure Shoulder Protocol

POST PROCEDURE PROTOCOL FOR REGENERATIVE SHOULDER PROCEDURES

• 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 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 sling for ____days, coming out to flex and extend the elbow twice daily

• NO ACTIVE lifting above shoulder height x 1 week; may do PASSIVELY after day 3

• Do not actively rotate your arm away from your body (keep hand between belly & your side) for 7 days and avoid sudden reaching out to side or behind you for 2 weeks.

• You can do simple pendulum exercises to help prevent a stiff shoulder

• f/u for PT in 4-7 days

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

First 2 Weeks:

• Strengthening/Motion: Isometrics are good for muscles and pain control. Gentle assisted and passive range of motion is good. PT will help with gentle range of motion.

• Walking: No restrictions.

• Cycling: May do a gentle ride on a stationary bike for 10-15 minutes, 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 using the other arm or stick.

• Cycling: No restrictions except to stay on an exercise bike until 4 weeks.

• Swimming: May begin gentle kicking and pool walking.

• Throwing/rock climbing/tennis: No throwing/rock climbing until after 6 weeks. May begin 10-15 minutes of ground strokes (noncompetitive) at 4 weeks.

 Weeks 4-6:

• Strengthening/Motion: Progress to moderate loading and progressive strengthening. Work on regaining 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 throwing program at 6 weeks.