Caution: 1.
1.The methods and data provided in this program are developed according to general routine, and the specific implementation should be done under the guidance of a doctor depending on your condition and surgery.
2. Pain during functional exercises is unavoidable. If the pain can subside to the original level within half an hour after the exercise is stopped, it will not cause damage to the tissue and should be tolerated.
3, muscle strength exercises should be concentrated until the muscle has a sense of soreness and fatigue, and then proceed to the next group after sufficient rest. The number of exercises, time, load depending on their own situation, and should be practiced at the same time the healthy side. The improvement of muscle strength is a key factor for joint stability, and must be practiced carefully.
4, in addition to the surgical limb brake protection, the rest of the body parts (such as the healthy side of the upper limb, waist and abdomen, lower limbs, etc.) should be practiced as much as possible to ensure physical quality, improve the overall level of circulation and metabolism, and promote the recovery of the surgical local.
5. Early passive joint mobility exercises should be performed only once a day, striving for improvement in angle, and avoiding repeated exercises. If there is no progress in mobility for a long time (>2 weeks), there is a possibility of joint adhesions, so we should pay great attention to it, overcome pain and fear, and insist on completing the exercises.
6.Ice packs should be applied for 20-30 minutes immediately after the mobility exercise. If you usually feel the joint swelling, pain and fever, you can apply ice again, 2-3 times a day.
7.The shaded side in the appendix is the affected side (referring to the operated side, the healthy side is the healthy side of the limb).
I. Early stage
Protection period (0-4 weeks)
Purpose: To reduce pain, swelling; early muscle strength exercises; early mobility exercises to avoid adhesions and muscle atrophy.
In the early stage of functional exercises and the early stage, the tissue inflammatory reaction is more obvious and more fragile.
Therefore, static exercises (limbs remain in a certain position, so that the muscles reach fatigue) are the main. Or later choose a light load (complete 30 movements that fatigue the load), 30 times / group, 2-4 groups of continuous exercises, 30 seconds rest between groups, until fatigue, endurance exercises.
In the early stage, attention should be paid to the protection of the triangular towel suspension, should not bear weight and excessive force. Otherwise, it will affect tissue healing and functional recovery.
(a) 0-3 or 4 weeks Triangular towel suspension in a comfortable position for protection (3 or 4 weeks depending on pain and muscle strength)
(1)On the day of surgery
1.After anesthesia subsides, start moving fingers and wrist joints.
2.Put a pillow under the arm on the operated side while lying in bed to keep the arm in a slightly forward-flexed position (slightly in front of the body side) to reduce pain.
(2) 1 day after surgery
”Open hand and fist” exercise – open the palm of your hand as wide as possible, slowly and forcefully, and hold it for 2 seconds, and hold it for 2 seconds with a firm fist. (It is important to promote circulation, reduce swelling and prevent deep vein thrombosis)
(3)3-4 days after surgery
”Shrugging” exercise DD the healthy side of the hand to hold the affected elbow protection, without increasing shoulder pain, shrug the shoulder upward, in the highest position for 5 seconds, relax for 1 time, repeatedly, 5 minutes / group, 1 group / hour.
”Chest expansion” exercise DD the healthy side of the hand to hold the affected elbow protection, without increasing the shoulder pain, the shoulders back to do chest expansion, in the maximum position to hold for 5 seconds, relax for 1 time, repeated, 5 minutes / group, 1 group / hour.
”DD hold the elbow on the affected side for protection, without increasing shoulder pain, do chest expansion with both shoulders back and front, hold in the maximum position for 5 seconds, relax for 1 time, repeat, 5 minutes/group, 1 group/hour.
× Continue the above exercises thereafter.
(4)1 week after surgery
At the discretion of the surgeon, start the “swing exercise” – bend your body forward (bend over) until your upper body is
The arm is swung under the protection of a triangular scarf and the healthy hand. The first one is in the anterior-posterior direction, and after getting used to the basic painlessness, increase the lateral ones to the left and right, and finally increase the circular movements (circles), 20-30 times/group in each direction, 1-2 groups/day, and apply ice for 20 minutes immediately after the exercise.
(5) 2 weeks after surgery
1) Start to move the elbow joint – protect and remove the triangular scarf, passively (by the rehabilitation doctor or with the healthy hand under guidance) slowly flex and extend the elbow joint in full range, 20-30 times/group, 2 groups/day. Wear a triangular scarf for protection immediately after the exercise.
2) Passive joint mobility exercises (all mobility exercises can be performed by a rehabilitation physician or other professional.
(All mobility exercises can be performed by rehabilitation doctors and other professionals, or by yourself after instruction.)
×Anterior flexion: within 90° range
Lie flat, remove the protection of the triangular scarf, and hold the affected elbow with the healthy hand (the affected limb should be completely relaxed and the healthy side should complete the movement with force!) Raise the affected arm upward vertically via the side of the body until pain is felt and stop for 2-3 minutes, then continue to increase the angle after the pain is relieved. Do not repeat!
×Abduction: within 60°
The posture and requirements are the same as before, and the affected arm is raised along the horizontal direction on the body side.
(6) 3 weeks after surgery
×Trial pain and muscle strength depends on the situation, and begin to gradually transition to the removal of the triangular scarf suspension protection.
Muscle strength exercises
DD flex the elbow at 90° and raise the arm in front of the body to a pain-free angle without shrugging the shoulder! In the highest position
Hold at the highest position for 2 minutes, rest for 5 seconds, 10 consecutive sets of 2-3 sets/day. Strength gain
Straighten the arm after strengthening.
DD arm raised to a pain-free angle at the side of the body, no shrugging! Hold in the highest position for 2
Hold in the highest position for 2 minutes, rest for 5 seconds, 10 consecutive sets for 1 set, 2-3 sets/day.
DD arm naturally drops to the side of the body, perform the above “shrugging” exercise. 30 reps/set, rest 30 seconds between sets.
Rest 30 seconds, 2-4 sets in a row. You can lift heavy objects after the strength is strengthened.
DD active, slow flexion and extension of the elbow joint, without increasing shoulder pain, 30 reps/group, 30 seconds rest between sets.
30 reps/group, 30 seconds of rest between groups, 2-4 groups in a row.
Joint mobility exercises (within 110° of forward flexion, 90° of abduction, 0° of posterior extension and external rotation in neutral position)
DD forward flexion and abduction in the same way as before, gradually increasing the angle.
DD external rotation: lying down, bending the elbow 90 °, the healthy side of the hand to hold the affected wrist, (the affected limb completely relaxed, the healthy side of the force to complete the action!) Push the affected arm outward in the vertical direction at the front of the body, stop for 2-3 minutes until pain is felt, and continue to increase the angle after the pain is relieved (maximum to the small arm perpendicular to the bed). Do not repeat!
DD posterior extension: the same posture as before, gradually put the small arm to the bed surface at the body side.
II. Mid-term
Mobility and muscle strength recovery period (4-8 weeks)
(1)4-6 weeks after surgery
Muscle strength exercises
DD continue and strengthen the above muscle strength exercises.
DD external rotation muscle strength exercises: sitting position, bend the elbow 90°, the healthy side hand holds the affected wrist, the healthy side
Inward affected side against outward force, painless angle, without really causing movement. Without increasing
Without increasing shoulder pain, 30 reps/group, 30 seconds break, 2-4 groups in a row.
DD posterior extension exercises: sitting position, arm naturally hanging down on the side of the body, the healthy side hand holding the affected side
wrist, the healthy side forward the affected side backward against the force, no pain angle, not really cause movement
The painless angle does not really cause movement. Without increasing shoulder pain, 30 reps/group, 30 seconds break, 2-4 groups in a row.
2-4 sets in a row.
Joint mobility exercises (within 130° of anterior flexion, 110° of abduction, 10-20° of posterior extension and external rotation)
DD sitting position, the affected arm is straight, the healthy side and the affected hand hold a wooden stick (crutches, clothes pole, etc.) respectively.
(The affected limb is completely relaxed and the movement is completed by the healthy side!)
Stretch slowly and forcefully to the front, top, side and back, gradually increasing the angle. Until you feel
Stop for 2-3 minutes when you feel pain, and continue to increase the angle after the pain is relieved.
DD sitting position, the affected arm is bent at 90°, the healthy side and the affected hand hold a wooden stick respectively, push the affected hand outward until the pain is felt and stop for 2-3 minutes, and continue to increase the angle after the pain is reduced.
(2)6-8 weeks after surgery
Muscle strength exercise
DD standing or sitting position, with the affected arm straight, holding one end of an elastic band and the other end of the band
Fix the other end of the band at a certain place and pull the band forward, laterally and posteriorly with force. (The amount of resistance can be adjusted by the tightness of the band.) Without increasing shoulder pain, perform 30 times/group with a 30-second break between groups, 2-4 groups in a row.
-D standing or sitting position, the affected arm is bent at 90°, the same method of holding the leather band as resistance, pulling the leather band with force medially and laterally. Requirements are the same as above.
DD elbow muscle strength exercises: use dumbbells etc. as load, actively extend and flex the elbow joint, gradually increase the number and weight without increasing shoulder pain.
Joint mobility exercises (within 150° of forward flexion, 130° of abduction, 20° of posterior extension, 60° of external rotation, 60° of horizontal adduction and 10° of horizontal abduction)
DD continue to strengthen the above exercises and gradually increase the angle.
DD “head-hugging” exercises: hands behind the head, stand against the wall, open both elbows backward, try to make the elbows can touch the wall. Stop for 2-3 minutes until you feel pain, and continue to increase the angle after the pain is reduced.
DD horizontal inversion exercise: stand or sit, hold the shoulder on the affected side with the affected hand, hold the elbow of the affected arm with the affected hand and lift it to shoulder level, then slowly pull the affected arm towards the healthy shoulder. Stop for 2-3 minutes until you feel pain, and continue to increase the angle after the pain has subsided.
DD horizontal abduction exercise: In the standing position, hold a fixed object (door or window frame, heating pipe, gym base, etc.) with the affected hand at the same height as the shoulder, keep the upper body straight, slowly turn to the healthy side, until the affected shoulder feels pain and pulling, stop for 2-3 minutes, and continue to increase the angle after the pain is reduced.
Third, later stage
Mobility and muscle strength strengthening period (8-12 weeks)
(1)8-12 weeks after surgery
DD strengthen the joint mobility until it is gradually the same as the healthy side.
DD strengthen muscle strength, start resistance muscle strength exercises in all directions, and gradually increase the load. Focus on absolute strength exercises. Choose a moderate load (the load that makes you feel fatigued after 20 reps), 20 reps/set, 2-4 sets in a row, with 60 seconds of rest between sets, until fatigue.
Begin to resume light exercise (avoid excessive force in too large a range!)
(2)Post 4-6 months
Shoulder and upper extremity exercises with dumbbells, etc. Shoulder and upper extremity resistance muscle exercises.
Do not participate in antagonistic training and throwing, bar, double bar, hoop, shooting and dunking exercises.
IV・Resumption of exercise period (7 months after surgery)
After the doctor’s review and examination, the decision will be made whether to resume throwing and antagonistic sports training.