- Manual therapy, based on simple exercises repeated several times a day by a motivated patient, is a key partner of the orthopedic surgeon, shoulder specialist.
- We only work with physical therapists who know our protocols and who we can trust to take care of the patient we are responsible for.
- As we will see later on videos, we have used, for 28 years, the same simple exercises that require no machines or special equipment, but only the hands of the physiotherapist, a rubber, a stick and motivation from the patient.
- We recommend two to three sessions of 30 minutes each week with the physiotherapist, and four 10-minute sessions done by the patient himself at home in the morning, at noon, in the afternoon and in the evening. Several short sessions are better than one long daily session. "The more often the shoulder is mobilized passively, the less pain there is."
- After a shoulder surgery, by micro surgical arthroscopy or opened method, post-operative rehabilitation accounts for 50% of the final functional outcome. It requires a skilled therapist and a motivated patient. We review the patient, 15 days, 6 weeks, 3 months and 6 months after surgery to monitor the smooth running of rehabilitation and timeliness of recovery and functionality of the operated shoulder.
- We never operate a patient whose shoulder is stiff, or who is unable to actively raise his arm after a fall. With the exception of fractures, shoulder surgery is never an emergency. It is better to make a pre-operative rehabilitation program and operate on a patient who recovered a flexible shoulder and active elevation of his arm. "Pre-operative rehabilitation is a time saver for after the operation".
- According to our experience, an effective rehabilitation also helps to stabilize, and even recover, 3 out of 4 patients (see video rehabilitation of painful and stiff shoulder).
- A specific proprioceptive rehabilitation protocol allows us to effectively treat a painful and unstable shoulder in the context of constitutional or established ligamentous hyperlaxity.
- To the operated patients residing outside Switzerland, we give a "Patient Booklet" which describes the different exercises that the patient will have to do by himself, step-by-step and according to the type of surgery performed. We can provide regular post-operative monitoring with Skype®.
- The successive stages of functional recovery after shoulder surgery are the same, regardless the type of procedure performed and whatever the method, arthroscopic or opened method. Delays only vary depending on the type of intervention.
- 1st stage: Recovering passive range of motion within 6 weeks or 3 months after surgery
- 2nd stage: Recovering active mobility within 6 weeks or 3 months after surgery
- 3rd stage: Strengthening exercises within 6 weeks or 3 months after surgery
- Driving is allowed in a variable period, within 6 weeks or 3 months after surgery
- Delays to return to work vary from the 6th week to the 3rd post-operative month, depending on the type of work, manual or not
Functional recovery after a shoulder surgery is not a race. The patient must respect the incompressible tissue healing time, which is six weeks. We often say: "Everything is played during the first 6 post-operative weeks." Any carelessness during this period (driving, computer, repetitive movements) will cause the onset of pain and its corollary, stiffness.
It is advisable to look at the page "Functional Results" for more information.