Active elbow motion is when your own muscles move the elbow back and forth.

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1 Initial Pstperative Shulder Care and Exercise: **Can be dne if a biceps tendesis has been perfrmed. If a biceps tendesis prcedure has been perfrmed, active elbw mtin is delayed up t 6 weeks. Please clarify with Dr. Witty if yu have any questins. Active elbw mtin is when yur wn muscles mve the elbw back and frth. - Vides are available n Dr. Witty s website. - These exercises can be started immediately after surgery t facilitate recvery and wrk tgether with yur prtcl with the therapist. - These can be dne as many times a day as pssible as cmfrt allws. Abductin Sling Applicatin: Please see the Initial Pstp Shulder Care Instructin frm fr details and pictures. - Many patients have questin abut hw t replace the sling withut any assistance - Set up the pillw and sling n a surface (table, bed, r similar). - Make sure the sling is stuck t the pillw by the velcr - Make sure the Velcr r clip fastners that clse the tp part f the sling are pen - While prtecting the injured shulder with the ppsite arm, lwer the injured arm int the sling n the table r ther surface - Yu can nw reach arund yur bdy as needed t fasten the straps Shwering: Please see the Initial Pstp Shulder Care Instructin frm fr details and pictures. - It is ften helpful t use a shwer chair t prtect the arm/shulder and simplify shwering. - Unstrap the sling and gently let the arm drp t the side f the bdy. - Once sling and pillw are ff, lean tward the same side as the injured shulder t create a space t get t the armpit. - Use the nn-injured arm fr washing and drying. - Reapply the sling and pillw as described abve. 1

2 Jeffrey B. Witty, M.D. Scapular Retractin Exercise: - These exercises shuld be dne while the shulder pillw and sling remain in place. - Start with yur nn-injured arm at the side. The injured arm will remain in the sling. (Sling is nt pictured belw) - While keeping upper bdy/chest upright, slwly pull yur shulder blades tgether. Again, the perative arm shuld remain in the sling during this exercise. 2

3 - Pretend that yu are pinching smething in between the tw shulder blades. - Once all the way retracted, hld them in psitin fr 3 5 secnds t wrk the muscles - Perfrm 3 sets f 10 repetitins, 3 times a day. Shulder Shrug Exercises: - Yur arm shuld stay in the sling as befre - While keeping yur injured arm in the sling, shrug yur shulders as if yu are trying t tuch the tips f yur shulders t yur ears. 3

4 - Hld fr a few secnds and then relax. - Perfrm 3 sets f 10 repetitins, 3 times a day. Passive Elbw Mtin: - The sling needs t be lsened fr these exercises. - Open the sling and allw the arm t fall t the side and hang freely. Hld the injured arm s wrist with the ppsite arm t supprt and mve it ut f the sling. - Gently bend (flex) the elbw as far as yu can taking abut 3 5 secnds t d s using nly the uninjured / ppsite arm t mve the injured extremity. 4

5 - Then slwly straighten (extend) the elbw all the way ver 3 5 secnds using the ppsite arm t supprt the injured arm as it mves dwnward. - Place arm back int sling when cmpleted. - Perfrm reps 3 times a day. Wrist Mtin: - The arm can remain in the sling r be dne ut f the sling. - Simply extend and flex the wrist back and frth against gravity. 5

6 - Perfrm abut reps 3 times a day. Hand Squeezes: - These can be perfrmed in r ut f the sling. - Yu can use any sft ball (tennis, racquetball, etc). Sme slings cme with their wn. - Squeeze the ball as many times as pssible thrughut the day. 6