Capsular Release
Download this rehabilitation protocol (PDF)
For patients and physiotherapists.
Week 0-2
Aims:
- Pain control
- Allow the wounds to heal
- Maintain overall mobility
- Axilla/armpit hygiene
Suggested treatment:
- Ice
- Regular pain relief
- Elbow/wrist/hand and neck ROM exercises
- Sling for comfort only
- Capsular stretching exercises
- Emphasise “normalised” movement patterns during ADLs
Week 2-6
Aims:
- Wean out of sling
- Increase ROM
- Enhance proprioception
- Optimise kinetic chain
Suggested treatment:
- Passive range of motion with graduation to AAROM
- Proprioceptive exercises – esp closed kinetic chain eg wall slide/table slides
- Rotator cuff activation
- gradually increase to isometric strengthening
Week 6-12
Aims:
- Minimal pain
- Achieve AROM at least peri-operative by 12/52
- Strengthening
- Return to activity/sport
Suggested treatment:
- Continue capsular/joint mobilisation
- Facilitate rotator cuff activation through normal ADLs. Strengthening to continue
- Continue to incorporate kinetic chain – eg squats/lunges with arm elevation
- Sport specific training below shoulder height
Week 12 and beyond
Aims:
- Full AROM
- Return to sports
Suggested treatment:
- Strengthening without restriction
- Sports specific rehabilitation
Some General Questions
What to expect after surgery:
- Most patients will stay a night post operatively
- After you wake up, you may notice your whole arm feels numb from the local anaesthetic applied to the nerves of your arm – this should wear off approximately 12 hours after surgery
- The next morning, you will be seen by the medical team and physiotherapists prior to your discharge
- You will be sent home with medications or a script to help with pain relief
Time in Sling:
- Generally, your sling is on for 2 weeks at most. If your shoulder feels comfortable in these two weeks, you are free to remove it.
Return to Activity
- Driving: when adequate range of motion and pain to allow safe control of the car and to react appropriately in an emergency. Both arms must be fully functional and on the wheel for this to occur. Usually dependent on time in sling.
Return to driving from 4 to 6 weeks post op - Work: desk based roles should be able to return once pain has settled – usually approximately 2 weeks after surgery. Those with more manual occupations may need specific recommendations and light duties are usually recommended
- Swimming: water based exercise is very helpful after surgery. No swimming until the wounds have healed – usually 2 weeks post operatively. Breaststroke by 6 weeks and freestyle by 12 weeks.
- Golf: usually requires significant rehab and time before adequate protection of the rotator cuff repair has occurred. Usually 3 to 6 months post op
- High Risk Sports (eg racquet sports, rock climbing, football, martial arts, skiing, horse riding). These sports are dependent on ROM, control and strength. Improvement in shoulder strength can be seen up to 2 years post operatively. Strength training/heavy lifting can commence from 12 weeks
Contact sports or those at risk of falls (skiing, horse riding) shouldn’t occur till 4-6 months post op
Concerns or questions?
If you have any concerns post operatively, or you would like further information, please contact Mr Lau through the VBJS on 03 5752 5020 or via email at admin@vbjs.com.au
If you need urgent medical help, call 000 or go to your nearest emergency department.
Patient information
These notes have been prepared by Mr Simon Lau. They are general overviews and information aimed for use by his patients. They reflect Mr Lau’s views, opinions and recommendations. They do not constitute medical advice. The contents are provided for information and education purposes only. Please seek Mr Lau’s specific advice with any questions regarding medical conditions and treatment.