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Rehabilitation after shoulder arthroplasty
The goal of rehabilitation after shoulder arthroplasty is restoration of functional shoulder mobility in a timely fashion. Biologic factors impose limitations in achieving mobility after shoulder arthroplasty. Histologically, collagenous connective tissues in the shoulder (tendons, ligaments, capsule) contract after shoulder arthroplasty. These connective tissues are subject to the biomechanical properties and limitations of collagen, including plasticity, stretching, and temperature sensitivity. The plasticity of collagen allows connective tissues to adapt to physiologic and pathologic conditions. Rehabilitation is designed to maximize these adaptations and provide functional recovery of mobility after shoulder arthroplasty. We use a hydrotherapy-based rehabilitation regimen after shoulder arthroplasty to regain shoulder mobility.
Principles of Hydrotherapy
Rehabilitation in a warm-water pool facilitates gain of mobility after shoulder arthroplasty. Rehabilitation with the shoulder submerged or partially submerged in warm water provides a “weightless” environment. This “weightlessness” allows the arm to find the best path to achieve a specific movement. Additionally, a warm-water environment provides comfort and improves proprioception while minimizing pain. Whereas thermal neutrality is obtained with water heated to 34°C (93.2°F), a water temperature of 35°C (95°F) increases skin comfort while raising body temperature less than 1°C, thus minimizing the risk of a heat-induced inflammatory response.
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