Exercises in the respective phases

Strengthening exercises during post-treatment of one shoulder Tep depend on the extent of movement and the course of wound healing. In the first 1-2 weeks, independent movement should be learned and resorption-promoting exercises should take place. Strengthening is not yet necessary in this phase because the Shoulder Tep is not yet fixed enough.

From the 3rd week on, exercises for the shoulder blade can be performed, which preferably come from the PNF. These exercises consist of tension exercises of the shoulder blade in the different directions of movement that the shoulder blade allows. Tensioning exercises of the head in the direction of rotation and retraction are also suitable for targeting the adjacent musculature.

If mobility improves, the best strength training is to move your arm and maintain isometric tension. From the 7th week onwards, careful stabilization training can be started. The patient learns to tense the muscles around the shoulder joint in a neutral position of the arm.

The therapist then presses the arm in different directions, so that the patient has to tense it. The next phase of stabilization is to hold the arm in one position and again, as with the first point, to tense the muscles in all directions. All 3 phases take place purely isometrically.

The arm pattern can also be included via PNF. With PNF, all movements of the arms or legs take place in three dimensions and provide for muscle activity in the everyday oriented movement. In this phase of wound healing it is important to stay within the range of movement and to give moderate resistance.

In addition, exercises can be performed with the Theraband. Especially important are the M. Latissimus, M. Deltoideus, Mm. Rhomboids, which can be trained by pulling from top to bottom.

If the patient has received permission from the doctor to exercise freely, all support exercises, stabilization exercises on spinning tops, and final dumbbell training can be performed. In the early phase, i.e. in the first 5 days postoperatively, the physiotherapy is slowly built up after a shoulder TEP. Light active and passive movement exercises in the pain-free area increase the blood circulation and lymph drainage in the operated area and thus promote wound healing.

The structures are mobilized in the process. Since there is usually a previous illness, it is to be expected that joint mobility will be restricted by the surrounding structures such as muscles, tendons, ligaments and capsule. Early mobilization is very important.However, long-term movement restrictions cannot be eliminated immediately.

Here it is important to implement long-term therapy measures and a homework program. With early mobilization it is important not to exceed given movement restrictions. It is also not permitted to work against resistance directly after the prosthesis has been inserted.

In the following physiotherapy after shoulder TEP, the range of movement is extended. Any existing relieving postures are corrected and the atrophied, i.e. weakly developed muscles are strengthened more and more. Techniques such as the abutting mobilization or exercises from the field of proprioceptive neuromuscular faciation (PNF) can be used.

Mobilization exercises can be found in the article Physiotherapy Mobilization exercises. With increasing resilience coordinative exercises can be taken up, like for example exercises with the ball. Once the shoulder TEP is stable, the physiological support can be started.

The supporting capacity of the joint is very important to stabilize the joint and to protect it from renewed overloading. Exercises such as the quadruped position or forearm support can be worked out slowly. Coordination training also becomes more important as the shoulder’s ability to bear weight increases.

The musculature must learn to stabilize the joint at the right moment. Throwing exercises can be performed to train the muscles’ ability to react. The correction of long-term movement restrictions and poor posture is also an important part of physiotherapy for shoulder TEP.

Detailed descriptions of exercises for the shoulder can be found in the articles:

Physiotherapy after a shoulder prosthesis
Exercises for the rotator cuff
Shoulder Impingement – exercises
Exercises for shoulder joint arthrosis

By intensive stretching of the musculature (within the permitted range of motion of the prosthesis!) and soft tissue treatment of shortened structures, the possible range of motion of the new joint should be established as far as possible. Newly developed joint positions should be stabilized by strengthening the muscles.

To avoid effects on surrounding joints, it is important to develop an awareness of the posture of the shoulder joint. It should be avoided to move the entire shoulder girdle, for example to lift the arm. This is a typical misbehaviour, which manifests itself through pain-related incorrect posture caused by the previous illness and can lead to painful neck tension or even incorrect loading of the spine.

The physiological movement behavior of the shoulder joint is to be regained. Exercises here should be close to everyday life – for example, reaching for an object on a shelf. The position of the joint should be consciously controlled with a mirror.

Strengthening the joint should never be at the expense of physiological mobility. The treatment of surrounding structures such as the cervical spine can supplement physiotherapy according to Shoulder TEP. Stretching exercises for the shoulder neck muscles or mobilizing exercises for the cervical spine are possible. You can find more detailed information on the topic of “Shoulder TEP pain” in this article.