Work and Activity Restrictions
• 0–6 weeks: No work, no use of operative hand
• 6 weeks–3 months: 5 lb weight limit in operative hand (ideally nothing heavier than a fork, knife, or toothbrush); can return to work using opposite hand only
• 3 months: No lifting greater than 10 pounds
• 4 months: No lifting greater than 20 pounds
• 5 months: No lifting greater than 30 pounds
• 6 months: Released from restrictions; return to work full duty
0–2 Weeks: Wound Rest / Immobilization
• Wear sling at all times except for elbow, wrist, and hand exercises
• Perform flexion and extension of the elbow, wrist, and hand 3–5 times per day
2–6 Weeks: Protect Repair and Maintain Motion
• Continue wearing the sling at all times for 2 additional weeks; may remove it 4 weeks after surgery
• Begin physical therapy 4 weeks post-op
– Perform JPL Exercises Phase I and gentle pendulums
– Complete 3–5 sets of JPL exercises per day, with 5 repetitions per set
• Continue elbow, wrist, and hand exercises
6 Weeks–3 Months: Regain Range of Motion
• Maintain a 5 lb weight limit on the operative side
• Continue formal physical therapy
– Transition to Phase II of JPL Exercises when comfortable with Phase I
– Transition to Phase III when comfortable with Phase II
– Begin pool exercises if available
• Perform active and passive ROM exercises
– Goal: full range of motion by the end of 3 months
3 Months: Strengthening
• Begin gentle strengthening with theraband: internal rotation, external rotation, low row, and biceps curl
• Add isotonic and isometric shoulder strengthening, including internal rotation, external rotation, abduction, extension, and forward flexion
• Use operative extremity to lift 10 lbs for 1 month, then 20 lbs for 1 month, then 30 lbs for 1 month
• Add wall push-ups
• Perform internal rotation stretching: cross-body and up-the-back with towel
• Continue JPL exercises at home as needed to retain ROM
