Monday, February 14, 2022

Protecting the rotator cuff after shoulder arthroplasty

A shoulder arthroplasty usually takes a stiff, painful, relatively unused glenohumeral joint and coverts it into a comfortable and flexible articulation. When this happens, the rotator cuff muscles - which have been relatively unused for years - are suddenly called into action to stabilize and power the new joint.  Patients have shoulder arthroplasty are understandably eager to regain power in the new joint. They start exercises they recall from their younger years, exercises from the internet, or exercises recommended by a well-meaning but poorly informed friend:












The safest approach is one that gradually applies increasing loads to the entirety of the shoulder muscle group - including the muscles around the scapula - instead of the notion of "isolating" individual shoulder muscles. The most important exercise is the progressive supine=>vertical press as shown at this link. Note the inclusion of the "press plus" in which the scapula is protracted at the end of the press up. We ask patients to comply with the "rule of 20", which means that they should only use a resistance that they can comfortably and smoothly press for at least 20 repetitions. Sudden, heavy, jerky exercises are avoided.


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Here are some videos that are of shoulder interest
Shoulder arthritis - what you need to know (see this link)
The smooth and move for irreparable cuff tears (see this link)
The total shoulder arthroplasty (see this link).
The ream and run technique is shown in this link.
The cuff tear arthropathy arthroplasty (see this link).
The reverse total shoulder arthroplasty (see this link).

Shoulder rehabilitation exercises (see this link).