Intended for licensed physical therapists coordinating care with Dr. Vasileff. Defer to the operative note and the surgeon’s office for patient-specific direction.
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Shoulder · Other

Manipulation Under Anesthesia + Capsular Release (Frozen Shoulder)

Post-operative protocol · Dr. Chris Vasileff, MD
For the treating physical therapist. This protocol is a guideline; progression is criteria-based and individualized. Defer to the operative note and the surgeon’s office for patient-specific direction.

Shoulder Manipulation Under Anesthesia + Capsular Release

  • Sling for comfort, discontinue within 1-2 days
  • Advance rehab as tolerated – NO pain, NO gain
  • Rehab frequency: 5x/week for 2 weeks, progress to 2-3x/week as need
  • In between @ home: aggressive stretching in all planes (3x/day)

Phase I – Passive Motion (Week 1 - 3)

Pendulums to warm-up

Passive range of motion and terminal stretching

  • SupineSeated External Rotation – Full
  • SupineSeated Forward Elevation - Full
  • Internal rotation – Full (with towel)
  • Cross body horizontal adduction
  • Sleeper stretch
  • Internal rotation with towel
  • External rotation in door
  • Door hang
  • Behind the head push
  • 90-90 external rotation in door
  • Ice: continue to ice on a regular basis. At least 20 minutes at a time, 4-5 times per day.
  • Shower: On post-op day 3
  • Appointment: your first therapy appointment should begin day after surgery.

Phase II – Active Motion (Week 4 - 6)

Continue with modalities and ROM outlined in Phase 1

  • Pendulums to warm-up
  • Passive range of motion and terminal stretching
    • Progress when PROM allows

    Phase III – Resisted (Week 6 - 8)Pendulums to warm up and continue with phase 2

    Progress when AROM allows

    • External and Internal Rotation
    • Standing forward punch
    • Seated Rows
    • Shoulder Shrugs
    • Bicep Curls
    • Bear Hugs

    Phase IV – Weight Training (‘Per PT discretion’)

    • Keep hands within eyesight, keep elbows bent, no long lever arms
    • Minimize overhead activities (below shoulder level)
    • No military press, pull-downs behind head, or wide grip bench
    • Gradual progression of resistance controlling velocity, duration, intensity, and frequency

    RETURN TO ACTIVITIES

    Computer As soon as tolerated

    Driving When no longer taking narcotics

    Elliptical 1 week

    Jogging 3 weeks

    Light Swimming 1 month

    Recreational Sports 2-3 months

    Other activities per surgeon/PT discretion

    **Heavy overhead lifting (military press), pull-down behind head, wide grip bench and dips are discouraged.

Questions about a protocol? Contact Dr. Vasileff’s office at (704) 865-0077.