Phase 01 · Weeks 0 – 6

0 – 6 weeks

Sling to be worn 24x7, except as below.
Permitted to remove sling when seated with the elbow and forearm completely supported; the hand can be used for eating, computer and paperwork etc.
It's important to move the fingers, hand and elbow as normally as possible.
With the wounds covered by a waterproof dressing, shower with arm resting in triangular sling or supported on the shower soap dish.
Review with surgeon at 2 weeks — then if permitted:
Commence gentle passive elevation 0 – 90°, using the opposite hand to support the elbow, beginning supine then progressing to the erect position. Aim for 180° by week 12.
Gentle passive external rotation, aiming for 100% by week 12.
Pendulum exercises from 2 weeks, when the wound has healed; let the arm float about gently in a pool with to-and-fro movements.
Active elbow, wrist and hand movements.
Begin static active deltoid and scapular stabiliser toning exercises.
No abduction, internal rotation or extension exercises.

Phase 02 · Weeks 6 – 12

6 – 12 weeks

After review with surgeon at the 6-week mark.
Remove sling, though you may need to wear the sling if in a rowdy crowd setting.
Continue passive stretching programme for elevation, external rotation, and begin internal rotation.
Introduce active-assisted then active movements of elevation, external and internal rotation, beginning supine (lying down) and progressing to erect.
Begin breaststroke stretching in a warm pool, standing initially then doing laps, 4 times weekly for 20 minutes.
No abduction exercises of any form until all other shoulder movement is normal, including scapulo-thoracic rhythm (premature abduction with a stiff shoulder can result in recurrence of impingement).

Phase 03 · Weeks 12 – 16

Phase 04 · Weeks 16 – 24

Progress to advanced stretching and strengthening gradually as tolerated by the patient.
Gradually increase overhead use of the arm.
Increase weights at work gradually, looking to a trial return to heavy labour around 24 weeks.

Phase 05 · Months 6+

Trial return to overhead / heavy / labouring work on a graduated basis.
Return to contact sports when strength is equal to the un-operated side.
Patient to continue their own stretching and strengthening program as part of their daily exercise regime.

Last reviewed: 2025-10-15.