slap

Day of Op	Axillary hygiene Finger, wrist and elbow exercises Teach how to remove sling and replace it safely before discharge
1 – 3/52	Polysling with body band for 3 weeks Closed chain active assisted in all directions as pain allows / mild stretch and good movement quality (eg hands on table and walk away, ER with stick resting forearms on a table, bilateral dusting table / wall) Core Stability and postural re-education Avoid resisted elbow flexion
3 - 6/52	Wean off Sling during day continue at night Active assisted progressing to active gleno-humeral flexion, abduction, internal and external rotation Scapular stabilising exercises as required Functional Rotator cuff strengthening exercises within ROM available and as comfort dictates Proprioceptive retraining
6/52 & beyond	Remove sling completely Progress active ROM in all directions with good humeral scapula rhythm Gradual introduction to resistance exercises within a pain free ROM Ensure good recruitment of rotator cuff through range especially posterior cuff Use manual techniques if required for persistent tightness Strengthen throughout ROM using activity / work / sport specific exercise Biceps exercises if required.

The Shoulder Surgeon | Specialist keyhole surgery for the treatment of shoulder and elbow problems