Phase 1 (within 1 week after surgery): ① After surgery, suspend the affected limb with a bandage to keep the shoulder joint inward, internally rotated and slightly flexed forward, and the elbow joint in a flexed position, and place a soft pillow on the upper arm to keep the shoulder flexed at 10°~20°. Encourage the patient to do deep inspiratory exercises. After the anesthesia subsides, the patient is instructed to make a fist for 6 seconds, then extend 5 fingers for 6 seconds, and flex and extend the wrist 4~5 times each. The patient was also assisted to perform one passive exercise of forward flexion and external rotation of the affected limb (90° of elbow flexion), each movement lasting 20 seconds. On the next day, the patient was instructed to make a fist with an open hand for 20 consecutive strokes, 3~4 times a day. The patient was instructed to perform forward flexion and external rotation of the affected limb with the support of the able-bodied hand, 3 times a day. Phase 2 (1~2 weeks after surgery): In addition to forceful hand opening and fist clenching, add the following exercises. ①”Pendulum-like” exercise. The patient should stand with both feet shoulder-width apart, bend forward at 90°, relax the shoulders, lower the upper arms naturally, and swing the affected limbs back and forth, left and right within the triangular scarf, with a range of activity from small to large, 15-20 times each time, 2~3 times a day. ② Active exercises of elbow flexion and extension and forearm internal and external rotation, 15-20 strokes each time, 3 times a day. ③Resistance exercises for wrist and fingers, 5~6 strokes each, gradually increasing to 20 strokes, 3 times a day. Stage 3 (from 3 weeks after surgery): ① Under the guidance and assistance of the medical staff, perform the shoulder inversion and internal rotation activities: touch the opposite ear to the back of the neck with the affected hand across the face, and lift a 50 cm long gymnastic stick or wooden stick from behind the back with the affected hand.
The affected hand holds up a gymnastic stick or wooden stick about 50 cm long from behind, and the healthy hand pulls the stick upward and maintains it for a few seconds. The above actions are done 20 times each, 3 times a day. ②Foreflexion exercise: standing position, with the healthy side to hold the affected side of the forearm high above the head, maintain 10 seconds, 10 times each time. With both hands 10 fingers interlocked, lift upward overhead, maintain 10 seconds, 10 times each time. The above actions 3 times a day. Internal and external rotation exercise: put the affected hand behind the back and touch the back and even the opposite scapula with the help of the healthy side, 10 times each time. 3 times a day. ④Abduction and external rotation training: Hold the head with 10 fingers of both hands, and do shoulder abduction and external rotation movements, 5 times each time, 3 times a day. Phase 4 (from 6 weeks after surgery): mainly include active exercise and resistance exercise, using pulleys to perform confrontation exercise between the affected limb and the healthy limb; using elastic bands to do resistance exercise of the affected limb; continue to increase the range of motion of the shoulder joint: climbing the wall with the affected limb, drawing circles on the ground with a stick, touching the opposite ear and shoulder with the affected hand across the face, etc., and doing rowing or swimming movements with both arms.