• Manual rehabilitation, based on simple exercises repeated several times a day by a motivated patient, is the essential partner of the orthopaedic surgeon specialising in the shoulder.
• We work only with physiotherapists who are familiar with our protocols and whom we can trust to look after the patients in our care.
• As we will see later in the videos, for the past 28 years we have used the same simple exercises, which require no machine and no special equipment—only the physiotherapist’s hands, a rubber band, a stick… and the patient’s motivation.
• We recommend two to three sessions per week, of 30 minutes each, with the physiotherapist, and four sessions of 10 minutes—morning, midday, afternoon and evening—to be done by the patient alone at home. Several short daily sessions are preferable to one long daily session. “The more often the shoulder is passively mobilised, the less pain there is.”
• After shoulder surgery, whether by arthroscopic microsurgery or the open method, post-operative rehabilitation accounts for half of the final functional result. It requires a competent physiotherapist and a motivated patient. We personally review our patients 15 days, 6 weeks, 3 months and 6 months after the operation, in order to monitor the proper course of rehabilitation and adherence to the timeframes for recovering the function of the operated shoulder.
• We never operate on a patient whose shoulder is stiff (ankylosed) or who is unable to actively raise the arm following a fall. With the exception of bone trauma, shoulder surgery is never an emergency. It is preferable to carry out pre-operative rehabilitation, which allows us to operate on a patient who has regained a supple shoulder and active elevation of the arm. “Pre-operative rehabilitation is just so much time gained on post-operative rehabilitation.”
• In our experience, effective rehabilitation also allows 3 out of 4 patients to be stabilised, or even cured (see the video on rehabilitation of a painful, stiff shoulder).
• A specific proprioceptive rehabilitation protocol enables us to effectively treat a painful, unstable shoulder in the context of constitutional or acquired ligamentous hyperlaxity.
• To patients who have been operated on and who live outside Switzerland, we provide a “Patient Booklet”, which describes step by step the various exercises they will need to do on their own, according to the type of surgery performed. We can provide regular post-operative monitoring via Skype®.
• The successive stages of functional recovery after shoulder surgery are the same, whatever the type of procedure performed and whatever the method—arthroscopic microsurgery or open surgery. Only the recovery timeframes vary according to the type of procedure.

– Stage 1: Recovery of passive range of motion within 3 to 6 weeks after surgery

– Stage 2: Recovery of active mobility within 6 weeks to 3 months after surgery

– Stage 3: Strengthening exercises from 6 weeks or 3 months after surgery

– Driving is permitted within a variable period, ranging from the 6th week to the 3rd month after surgery

– The time before returning to work varies from the 6th week to the 3rd month after surgery, depending on the type of occupation, manual or otherwise

Caution!

The functional recovery of a shoulder after surgery is not a race against the clock. The patient must respect the non-negotiable tissue-healing period of 6 weeks. We often say: “Everything is decided during the first 6 post-operative weeks.” Any carelessness during this period (driving, computer use, repetitive movements) will lead to the onset of pain and its corollary, stiffness (ankylosis).

We recommend that you watch the “Rehabilitation” chapter.