This protocol includes three phases. In each phase, your fingers and hands are clasped together.
When performing the exercises, do not pull your operative side with your good side. The good side should simply help control movements and prevent your operative arm from giving way.
All movements should progress as tolerated and should not be painful.
The key is to perform the exercises 3–5 times a day, completing 5 repetitions each time.

Phase 1 (2 Weeks After Surgery)

• While lying on your back, raise your arms to your forehead.
• When you reach the maximum height you can go without pain, straighten your elbows.
• Hold for a few seconds, then return your hands smoothly to your stomach.

Phase 2 (2–6 Weeks After Surgery)

• While sitting upright in a chair, repeat the exercises described above.
• Start with your hands resting on your lap, elevate to your forehead, straighten your elbows, then return your hands smoothly to your lap.
• When this becomes comfortable, begin bringing your hands above your head.

Phase 3 (6 Weeks to 6 Months After Surgery)

• Begin bringing your hands behind your head.
• Once your hands are behind your head, straighten your elbows before returning smoothly to the starting position.
• When your elbows are fully extended, your arms should be touching or nearly touching your ears.

Note

This protocol was originally designed to be performed in a warm pool, which provides buoyancy and helps loosen the muscles and soft tissues around your shoulder.
If you have access to a warm pool, you may find it helpful to do these exercises there once your incision is healed and you can safely submerge your arm.
Perform them for about 20 minutes, ideally under the supervision of a therapist.
If a pool is not available, perform the exercises at home or with a therapist on land.

Pool Exercises

• Start with your hands at your sides. Allow them to float to the water’s surface with one arm swinging forward and the other swinging backward.
• Repeat while alternating arms.
• After several repetitions, begin swinging one arm across your body to touch your opposite shoulder while the other arm swings behind you, as if reaching for your back pocket.
• Also practice clasping your hands together and externally rotating your arms.