Passive Range of Motion Exercises for the Shoulder After Surgery

The shoulder is the most flexible joint in the human body and its construction leaves it vulnerable to many kinds of injury. Most commonly, surgery is performed when there is damage to the rotator cuff, a group of tendons and muscles that connect the shoulder blade and upper arm. These muscles enable movement including lifting, overhead reaching and swimming. Recovery from surgery can be long, but several passive range-of-motion exercises can help reduce pain, rebuild strength and reduce problems in the long run.

Passive Range of Motion

• A passive range of motion (PROM) exercise is performed without actively using a muscle. They are performed on a patient by a nurse or physical therapist, done under the recommendation of a doctor or surgeon. The assistant serves as the initiator of the action, taking the stress off the joint that has been operated on. They start slowly very soon after surgery to prevent muscle loss or stiffness. More range is added over time.

Rules

• Any exercise should be practiced first with the physician or surgeon. This will help assure the patient knows them correctly, and gives an idea of limitations. Correctly doing the exercise will prevent over-exercising the muscle. All range-of-motion exercises should be done in a smooth and gentle manner. Always follow the caregiver's orders. The doctor will decide which exercises are best and how many repetitions should be done.

What to Do

• Start slowly. This is important to prevent damage or injury. It is especially important if the patient has muscle spasms or tightening. Move the joint only as far as is comfortable. Stop when you feel resistance. This will be a point where the joint will not bend anymore. Like any exercise, PROM exercises should be done every day, occasionally increasing the range of movements. Do them as close to the same time of the day as possible and make the patient comfortable by turning on music or a favorite television show. Break up the program into a few sessions per day to prevent tiring or soreness in the muscle.

When to Stop

• Stop if the patient begins to feel pain or discomfort. Make sure the patient knows to mention any feeling of pain right away. The caregiver should be alert to any signs or signals of pain and should never go beyond normal movement of the joint.

Shoulder Exercises

• With one hand under the patient's elbow, turn the patient's palm toward the body. Raise the arm forward and up until it touches the ear. Bring the arm slowly back down to the side. This can be repeated usually 10 to 15 times as prescribed by a doctor. Shoulder rotation is done by bringing the arm out to the side, bending the elbow so the thumb and fingers are pointing up. Rotate the arm until the thumb and fingers are pointing down.