Postop Physical Therapy
After shoulder surgery, physical therapy is necessary for
your shoulder to become strong and flexible enough to return to competitive
throwing. The therapy will vary depending on exactly what was done inside your
shoulder during surgery, and not all programs are the same. Also, not all
therapists are the same. There is difference in therapy for a 70 year old
person’s rotator cuff repair and a cuff repair done in a twenty year old
pitcher. You will be best served to have a therapist who is experienced in
caring for throwers. Many of my patients come from across the state and nation,
and through my baseball contacts I can help you find a good therapist in your
area after your surgery.
The physical therapy will focus on regaining your range of
motion (ROM) and strength without damaging the repair. This can be tricky, and
is difficult to do on your own. The therapist must understand the nature of the
repair and how strong it is so that the therapy can be safe and effective.
Communication between the therapist and surgeon is key. Because not all
therapists know the post-operative course for a thrower having a shoulder
repair, I have placed my rehabilitation protocols on my webpage (www.drlintner.com).
This way, my patients from other parts of Texas or the US (or any other country
for that matter) and his/her therapist can look on my webpage to see the
rehabilitation instructions for the type of procedure the patient had. Still, it
is helpful if the therapist is familiar with throwing mechanics and has
experience in caring for competitive throwers. The webpage protocols provide
guidelines but there is no substitute for experienced hands for your surgery
and therapy.
Therapy is different for each patient because each patient
will heal differently. Sometimes you will need therapy once or twice a week,
other times it may be five times per week. You and I will make this decision at
your follow up visits after surgery, and an experienced therapist can help us
decide how often you will need to go.
...Therapy is
different for each patient because each patient will heal differently....
Once the repair has healed
sufficiently, the therapy can be more aggressive to regain motion and strength.
Different repairs heal at different rates. Most labral repairs can tolerate
aggressive stretching after six weeks. Ligament and capsule repairs are similar.
Strengthening of the rotator cuff and scapular muscles takes another six weeks
or so, and the repair continues to heal during that time. Usually by three or
four months the repair and rotator cuff are both strong enough to allow light
throwing. Most athletes think they are ready to throw before the they actually
are, meaning the repair is not strong enough even though they feel good. Caution
is worthwhile. If you return to throwing too soon, the repair will fail and we
are back to square one
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