Physiotherapy After Surgery: What Rehab really involves for Shoulder, Elbow & Hand Surgery
Physiotherapy (or physical therapy) is a medical service that helps you recover movement, strength and function after surgery or injury. It uses guided exercises and techniques (like stretches, controlled movements, manual therapy, or thermal treatments) to gradually restore a joint’s flexibility and stability.
In practice, your therapist creates a structured exercise program to gently improve the range of motion and strengthen surrounding muscles, while also managing pain and swelling. For example, after shoulder surgery, you might begin simple pendulum arm swings or assisted lifts to loosen the joint, progressing over time to resistance exercises that rebuild strength.
Physiotherapy for the Shoulder, Elbow, and Hand
Shoulder Rehabilitation
After shoulder surgery, physiotherapy focuses first on gentle movements to regain shoulder flexibility. Exercises such as pendulum or assisted arm lifts are prescribed to restore motion and flexibility without straining healing tissues.
Over the following weeks, these advances to active strengthening, targeting the rotator cuff and scapular muscles, to improve stability and function. As Dr Brumby-Rendell notes, shoulder rehabilitation typically begins with gentle movements to prevent stiffness and then progresses to gradual strengthening exercises guided by a therapist. Consistent therapy helps avoid long-term stiffness and restores a normal range of motion.
Elbow Rehabilitation
The elbow is prone to stiffness, so early motion is key. Generally, a removable brace is used initially, but patients are encouraged to bend and straighten the elbow and rotate the forearm (pronation/supination) several times a day. Medical guidelines stress that the elbow should not be immobilized for a prolonged period after surgery.
In phase I (the first 1–2 weeks), the focus is on very gentle active range-of-motion exercises within a safe arc. As healing permits, therapy gradually increases this range and adds light strength exercises. After six weeks a splint may be removed to allow full motion, and strengthening begins so the elbow regains its power and function.
Hand & Wrist Rehabilitation
Hand therapy is a specialized form of physiotherapy for the wrist, hand and fingers. Therapy typically starts with fine motor exercises to keep the fingers and wrist mobile.
Simple movements such as bending the wrist up and down and slowly curling each finger are done repeatedly to stretch tendons and improve circulation. These exercises help reduce swelling and maintain flexibility.
Gradually, strengthening is introduced: for instance, gently squeezing a soft ball or making tight fists rebuilds grip strength while still respecting healing tissues. Throughout, therapists may use custom splints to protect repairs early on, removing them in stages as the hand becomes stronger.
Examples of Physiotherapy Practices
Range-of-motion exercises: These are gentle movements that take the joint through its available motion. For example, shoulder pendulum swings and supported arm lifts help recover shoulder flexibility. For the wrist and fingers, wrist bends and finger flexion/extension exercises maintain hand flexibility.
Manual therapy: Physiotherapists use hands-on techniques such as joint mobilization, soft-tissue massage or myofascial release to ease stiffness and improve mobility. For instance, a therapist might gently move your shoulder or elbow joint to stretch the capsule, or massage scar tissue to promote healing. Such hands-on therapy helps tissues regain their normal motion.
Splinting and bracing: Custom or hinged braces are often used to protect a joint during early rehab. For example, a thermoplastic elbow splint might be worn at 90° flexion for 4–6 weeks post-op. As rehab progresses, the brace is removed for exercises (e.g. at home or therapy sessions) and worn only when needed. Similarly, wrist guards or finger splints may be used initially, then gradually weaned off.
Strengthening exercises: Once initial healing is underway, targeted exercises rebuild muscle strength. Therapists often use resistance bands, light weights or body weight exercises. For shoulders, this might include gentle rotator cuff presses or scapular squeezes; for elbows, light elbow curls; for hands, grip exercises with a putty or ball. These should be done progressively gradual strengthening exercises guided by a physiotherapist to safely restore power.
Modalities: Various physical agents assist recovery. Ice packs are commonly applied after surgery to reduce pain and swelling (part of the RICE approach). After a few days, heat therapy can relax muscles and improve blood flow. Other modalities like ultrasound or electrical stimulation may be used to accelerate healing and control discomfort.
Education and functional training: A key part of physiotherapy is learning how to adapt daily activities safely. Therapists teach proper posture, lifting/carrying techniques, and ways to use the recovering limb in everyday tasks. This prevents re-injury and ensures a steady return to normal life. As one guide explains, therapists will include advice on how to alter your everyday activities to support healing.
How Dr. Oscar Brumby-Rendell Can Help
Dr. Oscar Brumby-Rendell is an Adelaide-based orthopaedic surgeon specializing in upper limb surgery (shoulder, elbow, wrist and hand). He works closely with physical and hand therapists to develop a personalized rehabilitation plan for each patient. Under his care, you’ll receive expert surgical treatment (if needed) and a structured post-operative therapy regimen designed for your specific injury.
Dr. Brumby-Rendell’s approach emphasizes gradual progress: you’ll begin with gentle, pain-guided movements to prevent stiffness and later advance to strengthening exercises, all under professional supervision. This tailored guidance; from early motion through to full recovery gives patients the best chance to regain function safely.
Ready to improve your recovery? Contact Dr. Brumby-Rendell’s office to schedule a consultation. As an upper-limb specialist, he can assess your condition and refer you to skilled therapists. By working with him, you’ll have a clear plan and support throughout your rehab journey.
