Exercises to Help Prepare for Shoulder Replacement Surgery

Patient/caregiver was instructed regarding excercises to help prepare shoulder replacement surgery as follows:

  • Pain in the joint can be a deterrent for participation in the exercise schedule. Taking a pain medication 30 minutes before the exercise schedule can help with better pain control and improved compliance with therapy.
  • Placing an ice pack on the shoulder joint for 30 minutes before and after the therapy session can add to control of pain and swelling in the joint.
  • These sets of exercises to stretch and relax the shoulder are to be performed 3 – 4 times every day. Fix scheduled time slots during your day to perform your shoulder exercises. Compliance with these exercises before surgery can help individuals have an easier and faster recovery from the shoulder replacement surgery.
  • Based on the condition of the shoulder and other coexisting factors, limitations could be recommended on performance of some exercises in some individuals. Check with your physician and therapist for any limitations recommended before performing these exercises.

 

Fist pump exercises:

  1. Pain and swelling in the shoulder joint in individuals with arthritis of the shoulder joint could limit the mobility and range of motion in the joint. Consequently, blood tends to pool in the deep veins of the limb and increase risk for clot formation.
  2. Fist pump exercises are important to keep the blood moving up along the veins in upper extremities, prevent pooling of blood in the limb, and thus prevent formation of clots.
  3. This exercise also helps with improving the grip strength in the arm affected. You can perform this exercise in either sitting up or laying down in bed.
  4. Pump the fist by closing it tightly for a count of 5 and relaxing it.
  5. You can also try squeezing a rubber ball tightly for a count of 5 and relaxing it. Repeat the task for 20 times every hour.
  6. Observe compliance with practicing the recommended number of fist pumps every day to help keep the blood moving.

 

Shoulder circles:

  1. This exercise helps as a warm-up before performing any stretches or exercises on the shoulder.
  2. Sit relaxed and gently move just your shoulders up & forward, then down & backward, thus completing a circle in forward direction.
  3. After performing 10 circular movements in this direction, you can reverse the direction by gently moving just your shoulders down & backward, then up & forward, thus completing a circle in backward direction.
  4. Perform 10 circular movements in backward direction too. Repeat the task for 10 times on each set of arm exercises, for a total of 3 sets a day.

 

Chest expansion:

  1. Poor posture of the chest with rounded shoulders can add stress on the shoulders resulting in pain.
  2. Expansion of chest with shoulders spread wide apart can help relieve the stress on the affected shoulder, aiding in pain relief. Stand upright with your arms on your sides. Slowly take both your hands towards your back and clasp them tight.
  3. This is the start point of this exercise. From this position, try moving your clasped hands in a downward and backward direction, until you meet some stiffness or discomfort in the affected shoulder.
  4. While moving your clasped hands, simultaneously try puffing your chest up and forward.
  5. Once you experience the stiffness or discomfort in the affected shoulder, hold the position for a count of 5, and relax by bringing both the arms and chest to the start point.
  6. Repeat the task for 20 times on each set of exercises, for a total of 3 sets a day.

 

Scapular squeezes:

  1. This exercise helps to strengthen the muscles around the shoulder blade and thus contributes to strengthening the shoulder joint.
  2. Stand straight and gently pinch your shoulder blades together back and down. Hold the position for 10 seconds and relax by bringing the scapulae to their respective positions.
  3. Repeat the exercise for 20 times on each set of arm exercises, for a total of 3 sets a day.

 

Passive shoulder stretch exercises:

  1. This exercise helps to stretch the shoulder joint and contributes to pain relief.
  2. Individuals can lean forward using the bad arm against a firm, stable surface, such as, a table or chair or kitchen countertop and rest the arm. Having one leg behind the other can provide wider base and better support to prevent a fall.
  3. From this position, take small steps backwards, which helps stretch the arm at the shoulder. Do not overdo on the stretch. Stretching the arm should only be until you experience some stiffness, limitation, or discomfort in the shoulder.
  4. Once you experience the stiffness or discomfort in the shoulder, stop stepping back, hold the arm in this stretched position for a count of 5, and relax by taking forward steps & standing up straight.
  5. Repeat the task for 10 times on each set of arm exercises, for a total of 3 sets a day.
  6. Make sure you are stable in this leaning forward position. Avoid this position, if it makes you feel dizzy.
  7. Seek caregiver assistance to perform this task, as needed. Check with your therapist, if this task can be modified to better suit your requirements.

 

Shoulder extension exercises:

  1. Stand straight with your hands turned on to your back and palms facing backward. Hold a cane with your hands at shoulder width. This is the start point of this exercise. From this position, lift the cane in your hands further back.
  2. Being the stronger arm, your good arm will lead this exercise.
  3. Lift the cane backward until you experience some stiffness, limitation, or discomfort in the affected shoulder joint.
  4. Once you experience the stiffness or discomfort in the affected shoulder joint, hold the cane in this position for a count of 5, and relax by bringing both the arms to the start point.
  5. Repeat the task for 20 times on each set of arm exercises, for a total of 3 sets a day.

 

Shoulder internal rotation exercises:

  1. Stand straight with your hands turned on to your back and palms facing backward.
  2. Hold a cane with your hands closest possible. This is the start point of this exercise. From this position, lift the cane in your hands further up.
  3. Lift the cane straight up until you experience some stiffness, limitation, or discomfort in the affected shoulder joint.
  4. Once you experience the stiffness or discomfort in the shoulder joint to be exercised, hold the cane in this position for a count of 5, and relax by bringing both the arms to the start point.
  5. Repeat the task for 20 times on each set of arm exercises, for a total of 3 sets a day.

 

Anterior elevation exercises:

  1. This exercise can be performed by having the affected arm out of the sling and resting it on a supportive pillow laying on to your side.  Have the arm bent at 90 degrees near the elbow.
  2. Holding the wrist of the affected arm with the good hand, elevate the affected arm straight up.
  3. Pull the affected arm over the head with the help of good arm, until you experience some stiffness, limitation, or discomfort in the affected shoulder joint.
  4. You can also perform this exercise by standing up against a wall and sliding the hand of the affected arm up on the wall slowly, until you experience some stiffness, limitation, or discomfort in the affected shoulder joint.
  5. You can choose to support the affected arm with the good arm, by supporting the elbow of the affected arm sliding up against the wall with the hand of good arm.
  6. Once you experience the stiffness or discomfort in the affected shoulder joint, hold the arm in this position for a count of 5, and relax by bringing the arm to the start position on to the supportive pillow.
  7. Repeat the task for 20 times on each set of arm exercises, for a total of 3 sets a day.

 

Crossarm stretch:

  1. This exercise can be performed by having the affected arm out of the sling and stand upright with your arms on your sides.
  2. Then cross over your body with the unaffected arm and hold the affected arm behind the elbow. This is the start point of this exercise.
  3. From this position, try crossing over the affected arm over the chest to the other side by pulling the elbow of the affected arm with the unaffected.
  4. While doing this, try not to bend the affected arm and keep it straight. Cross the affected arm over the chest until you experience some stiffness, limitation, or discomfort.
  5. Once you experience the stiffness or discomfort in the affected arm, hold the limb in this position for a count of 5, and relax by bringing both the arms to the start point.
  6. Repeat the task for 20 times on each set of arm exercises, for a total of 3 sets a day.

 

Passive external rotation:

  1. This is an exercise for the affected arm, with most of the work being done by the unaffected arm. This exercise helps with stretching and reducing the stiffness in the affected shoulder.
  2. You can relax the affected arm by bending it at 90 degrees near the elbow and resting the elbow on a supportive pillow laying on to your side, with the forearm across your trunk.
  3. This is the start point on this exercise. Holding the wrist of the affected arm with the unaffected, gently rotate the affected arm outwards to the extent possible or until you experience some stiffness, limitation, or discomfort in the shoulder joint.
  4. Once you experience the stiffness or discomfort in the shoulder, hold the affected arm in this position for a count of 5, and relax by bringing the affected arm back to the start position.
  5. Repeat the task for 20 times on each set of arm exercises, for a total of 3 sets a day.

 

Triceps stretch:

  1. This exercise can be performed by having the affected arm out of the sling and stand upright with your arms on your sides. Then cross over your body with the unaffected arm and hold the affected arm behind the elbow.
  2. This is the start point of this exercise. From this position, try bringing the affected arm up and over behind you to the extent possible, by pushing the elbow of the affected arm with the unaffected.
  3. Once you experience the stiffness or discomfort in the back of the affected arm, hold the limb in this position for a count of 5, and relax by bringing both the arms to the start point.
  4. Repeat the task for 20 times on each set of arm exercises, for a total of 3 sets a day.