Standard Post Proximal Humeral Fixation Rehabilitation Protocol:
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Aims:
The aim of the rehabilitation is to protect the are to protect the repair in the early stages and to maximally optimise function in the long-term.

General Points :
Do not push through pain – remember pain inhibits rotator cuff control
Do not sacrifice quality of movement for range of movement
Remember the patho-physiology of the repaired tendon is often degenerative and needs to be considered when progressing rehabilitation.

Immobilisation:
The patient is to wear a sling for 6 weeks. It can be removed to perform exercises as instructed by the physiotherapist.

Post Operative Instructions:

0-6 weeks:
Sling to be worn.
Hand, Wrist and Elbow exercises.
Pendular exercises.

Encourage optimal Scapulo-Thoracic position.
Active assisted External Rotation to neutral/0
o.
Active assisted elevation as comfort allows.

From 6 weeks:
Wean out of sling – light activities only.
Gradually increase External Rotation.
As External Rotation increases gradually increase Elevation Range of movement.
Active assisted exercises

From 8 weeks:
Active assisted progressing to short lever.
Supine and closed kinetic chain if appropriate
.

From 10 weeks:
Short lever progressing to Long lever exercises.

No resistance or open chain exercises until 12 weeks


12 weeks onwards:
Isometric exercises in variable starting positions progressing to
Resisted movements through range and strengthening



Functional Milestones and Activity Time Scales:

Driving
See general principles of rehabilitation.
Swimming 12 weeks plus.
Golf 12 weeks plus.

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