After shoulder surgery, physical therapy exercises are necessary for recovery. Shoulder surgery is performed for various reasons such as rotator cuff tear repair, shoulder impingement treatment or shoulder dislocation. Regardless of the type and reason for surgery, physical therapy exercises play a very important role in restoring strength, flexibility and range of motion of the shoulder joint. The main goals of physical therapy exercises after shoulder surgery are to reduce pain, minimize swelling, prevent stiffness, and improve overall shoulder function. These exercises are adjusted according to the extent of the injury and the needs of each patient. These exercises are designed to safely and gradually restore the strength and ability to move the muscles, ligaments and tendons of the shoulder. Why is it important to exercise after shoulder surgery? Exercise helps improve shoulder mobility, strength, and flexibility. Regular exercise two or three times a day, at least for 10 to 15 minutes in the first days after surgery, is essential for faster recovery. Remember to pay attention to the pain to choose the right exercises and do not do the exercises that cause pain. Since starting exercise too early or overdoing it will delay the recovery process, you need to know when to rest. In the early stages of recovery after surgery, physical therapy exercises focus on gentle movements and passive range of motion exercises. As the recovery process progresses, harder and more challenging exercises are included in the program to increase muscle strength and endurance. The physiotherapist guides the patient in each of the rehabilitation stages and adjusts the exercises accordingly by monitoring the patient's progress. Persistence and commitment in physical therapy exercises are the key to successful recovery. Although performing these exercises is sometimes difficult or challenging, remember that performing these exercises is necessary to regain maximum shoulder function and prevent complications such as frozen shoulder or muscle imbalances. It is important to note that the recovery schedule is different for each person and the prescribed exercises depend on the opinion of the surgeon and the evaluations of the therapist. Strictly following the prescribed exercise program and regular attendance at physical therapy sessions greatly increases the chances of successful rehabilitation and faster return to daily activities. How does physical therapy help shoulder recovery after impingement surgery Most shoulder impingement surgery specialists recommend postoperative physical therapy, and the patient should see a qualified physical therapist immediately after surgery. The surgeon may refer the patient to an approved physical therapist. The physiotherapist first examines the condition of the shoulder after the surgery and considers the surgery performed and the reason for the patient's surgery in his conclusion. They show the patient how to safely use arm slings, splints, and other assistive devices. After evaluating the patient's condition, the physiotherapist designs a personalized rehabilitation program to regain maximum strength and mobility of the injured shoulder. Passive range-of-motion exercises or other low-intensity exercise can be started a few days after surgery. These exercises help increase blood flow and prevent scar tissue from forming in the shoulder. After the recovery of the shoulder, you can do more difficult sports. The physical therapist can provide additional treatments to speed up the recovery process and reduce pain after surgery. If necessary, deep tissue massage, painkillers, ultrasound therapy and other auxiliary treatments can be considered. Shoulder physiotherapy after rotator cuff surgery Surgery to repair a rotator cuff tear often involves reattaching the tendon to the head of the humerus (upper arm bone). But a minor tear may only require a corrective procedure called debridement. A complete tear is repaired by sewing the tendon back to its original location in the humerus. Physiotherapy methods are always used in the treatment of rotator cuff tears. This protocol is to ensure proper recovery after the operation. Physical therapy after rotator cuff repair helps reduce pain and swelling, restore full range of motion over time, and restore strength to the shoulder joint. After surgery, the shoulder must be immobilized (the arm is in a sling) for 7 to 10 days to allow the tissues to heal. This is followed by light physical therapy focused on passive range of motion for 6 weeks. As the tissues and range of motion continue to improve, the treatment will gradually become more aggressive. Physical therapy focuses more on strengthening and improving active range of motion. Physiotherapy after shoulder replacement surgery Treatment will initially focus on managing the acute phase after surgery and restoring strength and function. ### First to third week of shoulder surgery Initial treatment focuses on minimizing postoperative complications, reducing acute symptoms, and initiating movement. Treatment will include the following: - Cryotherapy - Pain management - Using a sling - providing the necessary advice and teaching exercise while using a sling - Exercises for range of motion and strengthening elbows, wrists and hands to prevent stiffness and muscle atrophy (muscle loss) - Passive and active range of motion - Strengthening with isometric movements - Stabilization of the shoulder - Awareness of physical condition - Wound management Read more: Physiotherapy of shoulder muscle imbalance ### 4th to 6th week of shoulder surgery After four weeks, the sling should be removed and the patient should be encouraged to increase active range of motion and perform strengthening exercises. Treatment at this stage includes: - Increasing passive range of motion to full range of motion - Start working on the active range of motion - Stabilizing the shoulder - Deep tissue massage - Closed range of motion exercises - Stretching of the joint capsule - Proprioception exercises - Treatment of scar tissue ### 7th to 12th week of shoulder surgery Rehabilitation includes the specific exercises needed to perform functional activities and is directed toward progressing to regain full range of motion, strengthen muscles, and improve endurance. Treatment will include the following: Special stretches to reach the maximum active range of motion - Stretching movements - Deep tissue massage - Shoulder and shoulder stretching - Open and closed movement chain activities - Muscular endurance - Dividing functional activities into controllable parts - Exercises to increase the sense of proprioception Read more: Physiotherapy and rehabilitation after surgery ### After the twelfth week of shoulder surgery After the twelfth week, the patient's ability to move and strength improves to a great extent and approaches the pre-injury conditions. Full recovery sometimes takes up to 12 months, so the physical therapist designs a long-term and comprehensive rehabilitation program for the patient, which the patient must follow carefully, focusing on maximizing the use of the arm. Treatment will include the following: - Reaching the maximum range of motion - Advanced strengthening exercises to move through the range of motion - Advanced proprioception exercises - Functional exercises - Long term management