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Shoulder Exercises – Rooms

Shoulder Exercises – Rooms

Exercises

255A Beyers Naudé Dr,
Rustenburg, 0299
Tel: +27 (0)14 592 8322
www.physiotherapy.co.za
P.O.Box 21533
Protea Park
0305
Hospitale/Hospitals
Netcare Ferncrest/Life
Peglerae/Medicare
Tel: +27 (0)14 592 8322

Shoulder Rehabilitation after Rotator Cuff surgery

 

PROGRESSIVE EXERCISES

 

EXERCISES SHOULD NEVER BE EXCESSIVLY PAINFULL
REPEAT ALL EXERCISES APPROXAMITALY 10 TIMES

2 – 4 Weeks

N

1 - Passive flexion: (This excersice will improve the forward movement of the
shoulder).

a. Lie down comfortably on your back.
b. Fold both forearms across your chest, hold each elbow with the opposite hand.
c. Slowly lift both your arms away from the body opening up the armpits.
d. The healthy arm must do all the work, while the operated arm should just relax.

N

2 - Passive abduction: (This excersice will improve the outward movement of the shoulder).

a. Lie down comfortably on your back.
b. Keep your arm as straight as possible.
c. Walk/Crawl outwards with your hand to open up your armpit.

N

3 - Passive external rotation: (This excersice will improve the rotation of the shoulder).

a. Lie down comfortably on your back.
b. Bend your elbow 90°.
c. Allow gravity to just let the arm fall away from the body.
d. When this is comfortable:
          1. Hold a stick in both hands.
          2. Use the stick to gently push the hand further.

N

4 - Hot pack for pain and muscle spasm.

a. Put a hotpack on the affected muscles for up to 20 min.
b. Do not over heat the hotpack.
c. Be carefull not to burn.

4 – 6 Weeks
THESE EXERCISES WILL PROGRESS YOUR PREVIOUS EXERCISES
N

1 - Active assisted flexion:

a. Wall crawls.
          1. Stand infront of a wall.
          2. Place both hands on the wall.
          3. Use your fingers to crawl as high as possible up the wall.
          4. When you cannot crawl higher:
                    a. Try to put your elbows against the wall.
                    b.Try to touch the wall with your forehead
          5. Guide your arm down with your healthy hand.
b. Pulley 1.
          1. Use a small pulley and rope attatched above your head. If you do not have this improvise using a towel/rope/tie over a                                          rail/beam/branch.
          2. Use your healthy hand to pull the operated arm up as high as possible in front of you.
          3. Repeat this up and down movement.

N

2 - Active assisted abduction:

a. Table top/Window sill:
          1. Stand an arms length away from a table or window sill facing sideways.
          2. Rest your hand on the table.
          3. Slowly bend your knees in order to open up the armpit as far as possible.
          4. Slowly stand up.
b. Pulley 2.
          1. Use a small pulley and rope attatched above your head. If you do not have this improvise using a towel/rope/tie over a
              rail/beam/branch.
          2. Use your healthy hand to pull the operated arm up as high as possible away from your side.
          3. Repeat this up and down movement.

N

3 - Active assisted external rotation against wall:

a. Stand close to a wall. Face away from the wall.
b. Push your operated sides shoulder blade, buttock and elbow flat against the wall.
c. Bend your elbow 90°.
d. Use a stick to gently push your hand towards the wall.

N

4 - Hand behind back (HBB):

Always progress in the following order and only advance to the next exercise if possible without severe pain.

a. First touch your buttock on the same side as your operated arm.
b. Then touch the opposite buttock.
c. Then try to move your hand up to the small of your back
d. Then try to move your hand up inbetween your shoulder blades.
e. Now hold a towel behind your back and pull the hand up higher.

N

5 - Scapula retraction: (Pulling back shoulder blades)

a. Lie on your stomach.
b. Keep your arms at your sides.
c. Lift your shoulder blades up towards the ceiling and down to the buttocks.
d. Hold this position for 10 seconds.

6+ Weeks

N

1 - Light stretches: Progress weekly.

a. Hold the position for 30 secs.
b. Repeat 3 times.

N

2 - Active movement.

a. Flexion
          1. Short arm/chicken wing: bend your elbow and move your arm forward.
          2. Straight arm: keeping your arm straight move your arm forward.
b. Abduction
          1. Short arm/chicken wing: bend your elbow and move your arm outward.
          2. Straight arm: keeping your arm straight move your arm outward.

N

3 - Hand behind head.

a. Put your hand behind your head as if you are washing/brushing your hair.
b. Move your hand further down towards your neck.

N

4 - Scapula retraction: (Pulling back shoulder blades).

e. Lie on your stomach.
f. Keep your arms at your sides.
g. Lift your shoulder blades up towards the ceiling and down to the buttocks.
h. Lift your hand upwards toward the ceiling.
i. Hold this position for 10 seconds.

N

5 - Theraband exercises: NB both sides!

a. Flexion
          1. Tie the theraband to a door handle. Close the door.
          2. Face away from the door.
          3. Hold on to the other end.
          4. Slowly move your arm forwards to roughly 45°.
b. Extension
          1. Face the door.
          2. Hold on to the other end.
          3. Slowly move your arm backwards to roughly 45°.
c. Abduction
          1. Turn so that the healthy shoulder is closest to the door.
          2. Hold on to the other end.
          3. Slowly move your arm outwards to roughly 45°.
d. Adduction
          1. Turn so that the operated shoulder is closest to the door.
          2. Hold on to the other end.
          3. Slowly move your arm inwards to roughly 45°.
e. External rotation.
          1. Turn so that the healthy shoulder is closest to the door.
          2. Hold on to the other end.
          3. Bend your elbow 90°.
          4. Slowly turn your arm outwards as far as possible without your elbow leaving your side. (If you struggle with this keep a small towel                    between the elbow and your body.)
f. Internal rotation
          1. Turn so that the operated shoulder is closest to the door.
          2. Hold on to the other end.
          3. Bend your elbow 90°.
          4. Slowly turn your arm flat against your body without your elbow leaving your side. (If you struggle with this keep a small towel                              between the elbow and your body.)
g. Scapula setting
           1. Hold the theraband behind your back.
           2. Keep your hands close together.
           3. Gently pull on the theraband apart while taking your hands slightly down and backwards.

Download Exercises - ROTATORCUFF REPAIR for Rooms.pdf

(Download the complete hospital exercise guidelines document)

Shoulder Exercises – Rooms

Shoulder Exercises – Hospitals

Exercises

255A Beyers Naudé Dr,
Rustenburg, 0299
Tel: +27 (0)14 592 8322
www.physiotherapy.co.za
P.O.Box 21533
Protea Park
0305
Hospitale/Hospitals
Netcare Ferncrest/Life
Peglerae/Medicare
Tel: +27 (0)14 592 8322

Shoulder Rehabilitation after Rotator Cuff surgery

 

GENERAL INFORMATION AND ADVICE:

 

N

Number 1

The sling must be worn for 4-6 weeks (depending on doctor’s orders) in order for the tissue to heal properly. (See exercises for how to wear the sling).

N

Number 2

Do not lift your elbow away from the body using you operated shoulder’s muscles. This will put too much tension on the affected area and could result in the operated tissue tearing.

N

Number 3

Physiotherapy is very important 2 – 3 x per week (depending on each patient’s progress). The physio must ensure that the shoulder retains good movement and does not become stiff. The aim is to have as much movement as possibe when the sling comes off. This is a delicate process and must be monitored constantly in order not to damage the surgery. The physio will also adress neck stiffness, muscle spasms, pain and swelling.

N

Number 4

Only after the sling has been removed and the doctor/physio is happy that the healing is sufficient, may the patient start doing gentle strenghtening exercises.

N

Number 5

Keep the wound dry while the wound is dressed. Plasters can usually be removed after 14 days or as the doctor ordered. If your wounds are red,warm or have a yellow discharge contact the doctors rooms. Carefully wash under the armpit with a cloth without lifting your elbow away from your body.

N

Number 6

Button down shirts are easiest to wear. When dressing, your operated shoulder should be into the sleeve first. When undressing your operated shoulder should be undressed last.

N

Number 7

Do not sleep without the sling. Do not sleep on the operated shoulder. Use a pillow to support the operated shoulder and arm when sleeping on the healthy side.

N

Number 8

Do not lift or grab anything while the arm is in the sling. No sudden movements with the arm.

N

Number 9

No driving while your arm is still in the sling. Only start driving when you can safely drive without any pain and your shoulder is strong enough to perform all the necessary actions.

N

Number 10

Maintain good posture (See exercises for examples of good posture).

N

Number 11

For swelling and pain ice and heat can be used (See exercises for time specific management).

N

Number 12

Do not do any gym exercises before 12 weeks post surgery. Consult your physio for a biokineticist referral
if you want to start doing gym exercises. The following exercises must preferably not be done in the gym
again:

a) Upward rows
b) Military Presses
c) Front/lateral fly’s
d) Dips

N

Number 13

Do not lift any heavy objects or play sport before a biokineticist is satisfied that you have reached the final stages of your gym-rehab.

EXERCISES:

0-2 Weeks
EXERCISES SHOULD NEVER BE EXCESSIVLY PAINFULL
REPEAT ALL EXERCISES APPROXAMITALY 10 TIMES

 

'

1 - Breathing Exercises

a. Sit or lie down comforatably.
b. Breath in through your nose.
c. Breath out through your mouth.
d. Keep your shoulders relaxed.
          1. Take a deep breath in and out.
          2. Take a deep breath in, hold for 3-5 sec and breathe out.
          3. Take a deep breath in, then a bit more in, and breathe out.

'

2 - Pendulem exercises:

a. Keep your back straight.
b. Use your body movement to get your arm swinging passively.
          1. Straight forward and backwards.
          2. Straight sideways from left to right.
          3. In small circles clockwise and anti-clockwise.

'

3 - Shoulder protraction/retraction:

a. Lie down on your back.
b. Lift your shoulders off the bed (forward).
c. Relax your shoulders and push your shoulder blades flat against the bed (backwards).
d. When you are comforatable with this exercise you can also do it while sitting.

'

4 - Elevation/ depression:

a. Lie down on your back.
b. Lift your shoulders up towards your ears.
c. Relax your shoulders and push then down towards your feet.
d. When you are comforatable with this exercise you can also do it while sitting

'

5 - Posture correction:

a. Sit on a hard chair.
b. Keep your back straight.
c. Pull in your stomach.
d. Tuck your chin backwards (ie make a dubble chin).
e. Pull your shoulder blades slightly down and backwards.
f. Now hold this position for 10 seconds.

'

6 - Circulation exercises to prevent blood clotting:

a. Keep your arm close to your body.
b. Carefully remove your forearm from the sling.
c. Use your healthy hand to stabilise your operated upper arm.
d. Gently do the following movements.
          1. Straighten and bend the elbow.
          2. Turn your hand up toward the roof and down toward the floor.
          3. Move your wrist in circles.
          4. Exercise your fingers.

'

7 - Ice for swelling and pain:

a. Cover the surgerical site with a clean sheet of plastic or a towel in order the protect the wounds and dressings.
b. Put an ice pack over your swollen or painful areas.
c. Keep it on for 10-15 minutes.
d. You can do this 3 times per day.

'

8 - Put the sling on correctly:

a. The strap around your neck should not be too tight.
b. The strap around your body should be nice and tight.
c. Your arm should be against your body.
d. Your elbow should be bend to 90°.
e. Your wrist should be well supported.

Download Exercises - ROTATORCUFF REPAIR for Hospitals.pdf

(Download the complete hospital exercise guidelines document)

Important!

All shoulder surgery patients require physiotherapy after dicharge from the hospital, to prevent post-operative complications and failure of surgery.

  • You will need 2-3 sessions/ week. Please phone the practice for an appointment ASAP.

 

Shoulder Exercises – Rooms

Back Surgery Exercises – Rooms

Exercises

255A Beyers Naudé Dr,
Rustenburg, 0299
Tel: +27 (0)14 592 8322
www.physiotherapy.co.za
P.O.Box 21533
Protea Park
0305
Hospitale/Hospitals
Netcare Ferncrest/Life
Peglerae/Medicare
Tel: +27 (0)14 592 8322

Lumbar Surgery

(Decompression, Fusion, Prosthesis, Laminectomy)

 

PROGRESSIVE EXERCISES

 

Do these exercises exactly as your physio prescribed.
Do not skip ahead to the next exercise until you have the permission of your physio.
Exercises should be done on both sides.

N

1 - Leg Stretches

a. Gluteus 1
b. Gluteus 2
c. Piriformis
d. Hamstring stretches

N

2 - Nerve tissue mobility

a. Lie down on your back.
b. Bend one knee as far as possible.
c. Hold your leg up with your hands behind your knee.
d. Your hip should be about 90° bend.
e. Gently straighten the knee upwards until you feel a gentle stretch.
f. Make sure that your thigh does not move.
g. Move your leg up and down 20 times.

N

3 - Straight leg raise

a. Lie down on your back.
b. Bend one knee up.
c. Lift the other leg straight up towards the ceiling.
d. Make sure your toes stay upright.
e. SLOWLY lower your leg.

N

4 - Core Activation

a. Lie down on your back.
b. Bend both knees up.
c. Press your back flat against the bed.
d. Try to move your belly button up towards your neck and in towards your spine.
e. Hold for 5-10 seconds.

N

5 - Bridging

a. Lie down on your back.
b. Bend both knees up.
c. Press your back flat as with exercise 4.
d. SLOWLY lift your buttock towards the ceiling.

N

6 - Active Range of Motion: start all ex’s with the brace on. Once comfortable repeat without the
brace.

a. Flexion
          1. Place your hands on your thighs.
          2. Slowly slide your hands down towards your knees.
          3. Hold for 3-5 seconds.
          4. Slowly use your hands to climb back up.
b. Extension
          1. Stand close to a stable surface.
          2. Bend slightly backwards.
          3. Return to the upright posisiton.
c. Side flexion
          1. Place your hands at your sides.
          2. Slowly slide your left hand down to your left knee.
          3. Hold for 3-5 seconds.
          4. Slowly return to the upright position.
          5. Repeat to your right.

N

7 - Once you have pain free range of motion you may start with more advanced
core exercises. Please ask your physio to assist you with this.

Download Exercises - LX SURGERY for Rooms.pdf

(Download the complete hospital exercise guidelines document)

Shoulder Exercises – Rooms

Back Surgery Exercises – Hospitals

Exercises

255A Beyers Naudé Dr,
Rustenburg, 0299
Tel: +27 (0)14 592 8322
www.physiotherapy.co.za
P.O.Box 21533
Protea Park
0305
Hospitale/Hospitals
Netcare Ferncrest/Life
Peglerae/Medicare
Tel: +27 (0)14 592 8322

Cervical Surgery

(Decompression, Fusion, Prosthesis)

 

GENERAL INFORMATION AND ADVICE:

 

N

Number 1

Wear your lumbar brace as prescribed by your doctor, usually at all times for at least 6 weeks.

N

Number 2

No sitting for the first 2 weeks. There after you may sit for short periods of 5-10 min if no pain or discomfort is felt. If you had a prosthesis replacing a disc you may sit from day 2.

N

Number 3

Avoid lifting or carrying anything heavy. Avoid reaching for things overhead. Lifting and carrying put extra stress on your healing tissue and muscles and should therefore be avoided for at least 6 weeks.

N

Number 4

Only start driving when you can safely drive without any pain and your back is moveable enough to perform all the nessasary actions. You may be a passenger in a car for short periods at a time. It is advicable to lie down on the back seat with your knees pulled up as you may not sit.

N

Number 5

Keep the wound dry while the wound is dressed. Plasters can usually be removed after 14 days or as the doctor ordered. If your wounds are red,warm or have a yellow discharge contact the doctors rooms.

N

Number 6: Showering & Bathing

– For the first two days after discharge from the hospital preferably a sponge or washcloth type bath.
– After the third day you can take a shower if you securely tape something over the dressing so that it does not get wet. Be prepared to change the dressing immediately if it does get wet or becomes loose.
– It is important when you take a shower to have somebody around to assist you.
– If you don’t have a shower at home, you may sit on the edge of the bath or stand in the bath while someone assists you with washing.

N

Number 7

One of our physiotherapists will evaluate and treat you post operatively. Please do all the exercises given by the physiotherapist to improve your lung function, circulation, joint movement and general functional ability. You will need to follow up with physio visits, please phone the rooms for an appointment ASAP. Physiotherapy treatments will be approximately 2-3 times per week, depending on your progress.

Physiotherapy treatment post operatively is important for the following reasons:
– To reduce pain, muscle spasm, swelling and inflammation.
– To retain normal movement in the spine, hips knees and ankles.
– To retain good mobility of nerve tissue.
– To improve body posture.
– To ensure proper healing of the surgical scar.
– To regain proper strength of the back, stomach and leg muscles.
– To give advice on do’s and dont’s
– To show the correct ways to stretch your muscles.

N

Number 8

It is important to stand and walk in increasing amounts every day. Please make a determined effort to walk at least three times a day increasing your distance and speed daily. This improves fitness and blood circulation to prevent blood clotting.( If a burning pain is felt in the leg please report to the doctors rooms.)

N

Number 9

Remember to roll onto your side when getting out of or into bed. Remember that your hip and shoulder should always roll together. (See exercises for examples on how to get in and out of your bed)

N

Number 10

Always sleep with a firm pillow between your legs in side lying or a pillow under your knees when sleeping on your back.

N

Number 11

If you have received orthopaedic stockings use them as prescribed. They are used to control swelling and to prevent blood clotting.

N

Number 12

For swelling and pain ice and heat can be used (See exercises for time specific management).

N

Number 13

The exact date for returning to work and driving will be discussed with you doctor.

N

Number 14

 Do not do any gym exercises before 12 weeks post surgery. Consult your physio for a biokineticist referral if you want to start doing gym exercises.

N

Number 15

Do not lift any heavy objects or play sport before a biokineticist is satisfied that you have reached the final stages of your gym-rehab.

EXERCISES:

0-2 Weeks
EXERCISES SHOULD NEVER BE EXCESSIVLY PAINFULL
REPEAT ALL EXERCISES APPROXAMITALY 10 TIMES

 

'

1 - Breathing Exercises

a. Lie down comfortably.
b. Breath in through your nose.
c. Breath out through your mouth.
d. Keep your shoulders relaxed.
          1. Take a deep breath in and out.
          2. Take a deep breath in, hold for 3-5 sec and breath out.
          3. Take a deep breath in, then a bit more in, and breathe out.

'

2 - Circulation exercises to prevent blood clotting:

a. Footpumps
          1. Keep your knee still,
          2. Move your foot up and down, in and out, and in circles
b. Heelslides
          1. Keeping your heel on the bed.
          2. Move your heel to your buttock as far as possible.
          3. Straighten your knee again.
c. Move and use your arms during the day.

'

3 - Stomach Crunches

a. Lie down on your back.
b. Bend your knees to 45°.
c. Cross your arms across your chest.
d. Tuck your chin towards your breast bone.
e. Gently lift your head and shoulders off the bed.
f. Hold 3-5 seconds.

'

4 - Static Excercises

a. Quadriceps
          1. Lie down on your back with your knees straight.
          2. Push your knee as flat into the bed as possible.
          3. Hold 5-10 seconds.
b. Gluteus
          1. Lie down on your back with your knees straight.
          2. Squeeze your buttocks together.
          3. Hold 5-10 seconds.
c. Calves
          1. Lie down on your back with your knees straight.
          2. Point your toes.
          3. Hold 5-10 seconds.
d. Back muscles
          1. Lie down on your back with your knees straight.
          2. Squeeze your buttocks together.
          3. Press both your shoulder blades and calves gently down into the bed.
          4. Hold 5-10 seconds.
          5. Later when this is comfortable
                    a. Press the opposite shoulder blade and calf into the bed.
e. Adductors
          1. Lie down on your back.
          2. Bend your knees up to 45°.
          3. Squeeze a pillow/ball between your knees.
          4. Hold 5-10 seconds.

'

5 - Ice for swelling and pain

a. Cover the surgery site with a clean sheet of plastic or a towel in order the protect the wounds and dressings.
b. Put an ice pack over your swollen or painfull areas.
c. Keep it on for 10-15 minutes.
d. You can do this 3 times per day.

'

6 - In and out of bed:

a. Into bed
          1. Sit on the bed.
          2. Slowly lie down on your shoulders.
          3. Pick your legs up onto the bed.
          4. Roll onto your back moving your shoulder and hip together.
b. Out of bed
          1. Turn onto your side moving your shoulder and hip together.
          2. Lower your legs off the bed.
          3. Slowly push up on your arms.
          4. Push up until you are sitting.
          5. Slowly stand up.

Download Exercises - LX SURGERY for Hospitals.pdf

(Download the complete hospital exercise guidelines document)

Important!

All lumbar surgery patients require physiotherapy after dicharge from the hospital, to prevent post-operative complications and failure of surgery.

  • You will need 2-3 sessions/ week. Please phone the practice for an appointment ASAP.

 

Shoulder Exercises – Rooms

Neck Surgery Exercises – Rooms

Exercises

255A Beyers Naudé Dr,
Rustenburg, 0299
Tel: +27 (0)14 592 8322
www.physiotherapy.co.za
P.O.Box 21533
Protea Park
0305
Hospitale/Hospitals
Netcare Ferncrest/Life
Peglerae/Medicare
Tel: +27 (0)14 592 8322

Cervical Surgery

(Decompression, Fusion, Prosthesis)

 

PROGRESSIVE EXERCISES

 

N

Shoulder Stretches

a. Progress weekly.
b. Hold the position for 30 secs.
c. Repeat 3 times

N

Shoulder blade stability

a. Hold the theraband behind your back.
b. Keep your hands close together.
c. Gently pull on the theraband apart while taking your hands slightly down and backwards.

N

Nerve tissue mobility

a. Sit with good posture.
b. Stretch your arm out to the side, opening up your armpit to 90°.
c. Keep your elbow straight.
d. Turn your arm so that your palm faces up.
e. Bend your wrist up and down slowly.

N

Static strengthening

  1. Neck flexion
    1. Sit with good posture.
    2. Place your palm on your forehead.
    3. Gently press your head forward while your hand blocks the movement.
    4. Hold 5-7 seconds.
  2. Neck extension
    1. Sit with good posture.
    2. Place your palm on your forehead.
    3. Gently press your head forward while your hand blocks the movement.
    4. Hold 5-7 seconds.
  3. Neck rotation
    1. Sit with good posture.
    2. Place your palm on your chin.
    3. Gently press your chin towards your shoulder while your hand blocks the movement.
    4. Hold 5-7 seconds.
  4. Neck side flexion
    1. Sit with good posture.
    2. Place your palm just above your head.
    3. Gently press your ear towards your shoulder while your hand blocks the movement.
    4. Hold 3-5 seconds.
N

Deep Neck flexors

a. Lie on your back.
b. Set your shoulder blades, the same movement as in exercise 2.
c. Tuck your chin in, pulling the top of your head upwards toward
the ceiling ie make a double chin.
d. Hold for 5-10 seconds.
e. When this is comfortable, try in sitting.

N

Neck mobility – do not force movement into pain.

  1. Upper Neck flexion
    1. Sit with good posture.
    2. Tucking your chin in. (See example #5 in .pdf below)
    3. Slowly return to starting position.
  2. Upper Neck extension
    1. Sit with good posture.
    2. Push your chin forward as far as possible.
    3. Slowly return to starting position.
  3. Lower Neck flexion
    1. Sit with good posture.
    2. Look down tucking your chin towards your chest.
    3. Slowly return to starting position.
  4. Lower Neck extension
    1. Sit with good posture.
    2. Look up towards the ceiling.
    3. Make sure not to turn or bend your neck sideways.
    4. Slowly return to starting position.
  5. Neck rotation
    1. Sit with good posture.
    2. Turn your chin towards your shoulder.
    3. Slowly return to starting position.
  6. Neck side flexion
    1. Sit with good posture.
    2. Move your ear closer to your shoulder.
    3. Slowly return to starting position.
Download Exercises - CX SURGERY for Rooms.pdf

(Download the complete hospital exercise guidelines document)

Important!

All neck surgery patients require physiotherapy after dicharge from the hospital, to prevent post-operative
complications and failure of surgery.

  • You will need 2-3 sessions/ week. Please phone the practice for an appointment ASAP.