Elbow Replacement Protocol

Prior to total elbow replacement surgery for elbow arthritis, you are advised to visit your physiotherapist to make sure you are ready for your post-op rehab.

Pre-Surgery Preparation

Prior to total elbow replacement surgery for elbow arthritis, you are advised to visit your physiotherapist to make sure you are ready for your post-op rehab.

Dr Gupta recommends;

  • Wear a soft posterior elbow splint fixed at 60 degrees of flexion after your operation
  • Game Ready ice and compression therapy fitting and instructions explained
  • Your Post Op Rehab Protocol explained

Post Operative Rehab

You will achieve the best surgical outcome if you follow up surgery with a complimentary course of rehabilitation. The below outlines recommendations of your rehab over the first 3 months following your procedure;

Self Guided Activities 

Often described as the toughest part of your recovery, the first 6 weeks post op are painful and limiting. You are required to;

  • Keep your wound dry
  • Wear your elbow brace day and night for 2 days and then day only for 6 weeks 
  • Confirm your 2 week post op appointment with Dr Gupta
  • Use your pain medication as prescribed by your GP doctor
  • Use your rented Game Ready ice treatment as recommended from 0-4 weeks
  • Visit your physiotherapist 4-5 times a week and repeat your physio session by yourself daily from 0-4 weeks
  • Decrease your physiotherapy visits to 2-3 times a week and repeat exercises daily from 4-8 weeks
  • Decrease your physiotherapy visits to 1-2 times per week and repeat exercises daily from 8-12 weeks
  • Decrease your physiotherapy visits to 1 time per fortnight and repeat exercises daily from 12 weeks until full recovery
  • Confirm your 3 month post op follow up appointment with Dr Gupta

Physiotherapy 

1-6 Weeks

Priority no.1 is to protect the area of surgical repair to allow for healing. Minimise active movement, maintain passive movement of wrist, shoulder and neck, maintain contra lateral strength and commence limited passive elbow ROM.

  • Remove brace for physio
  • Wear a sling as required after physio for comfort

Stretching/Passive Movement Exercises

  • Gravity assisted limited flexion extension, limited movements at a desk, 3x15 touch either side
  • Gravity assisted limited supination pronation, limited movements at a desk, 3x15 touch either side

Strength Exercises

  • Grip strength exercises, 3x15 reps of 3 second holds
  • Wrist curl 3x15 reps using theraband resistance as tolerated
  • Shoulder blade retraction exercises completing 3x10 reps of 5 second holds
  • Shouler flexion using a broom stick and bent elbows up to 90 degree shoulder flexion
  • Neck movements, front, back, side to side, rotation left and right
  • Non-affected side as per above

Recovery and Pain

  • Scar and swelling massage
  • Ice and compression therapy like Game Ready
  • Interferrential if preferred

6-12 Weeks

Priority no.1 is to improve active and passive movement of the shoulder up to shoulder height in this phase.

  • Brace no longer required
  • Above shoulder exercises not allowed at home, but to be commenced at the physio

Stretching Exercises (commencing active ROM movements)

  • Standing arms behind back rolling broom handle up and down
  • Sitting internal and external rotation broom handle stretches at a table, 3x10 to each side

Shoulder Strength Exercises

  • Shoulder blade retraction exercises, 3x10 reps of 5 second holds
  • Lower traps exercises using contract and hold efforts, 3x10 reps of 5 second holds
  • Co-contraction Elbow flexion extension, 3x10 efforts of 5 second holds
  • Isometric external rotation, 3x10reps of 5 second holds
  • Isometric internal rotation, 3x10reps of 5 second holds
  • Isometric flexion, 3x10reps of 5 second holds
  • Isometric extension, 3x10reps of 5 second holds
  • Isometric adduction, 3x10 reps of 5 second holds
  • Non-affected side as per above

Recovery and Pain

  • Scar and swelling massage
  • Ice and compression therapy like Game Ready
  • Interferrential if preferred

12 Weeks to Full Recovery

Priority no.1 is completing max shoulder ROM and improving strength during this phase.

  • Tennis, throwing activities and heavy lifting are NOT ALLOWED FOR LIFE

Stretching Exercises

  • Shoulder flexion as tolerated in standing against wall 3x10reps of 5 second holds building to full flexion
  • Elbow flexion as tolerated holding door frame, 3x10 5 second holds

Shoulder Strength Exercises using appropriate theraband as tolerated

  • Internal/ external rotation with the shoulder by side, 3x10 reps
  • Seated row, 3x10 reps
  • Shoulder adduction, 3x10 reps
  • Shoulder flexion/ extension using a pulley or similar 3x10 of each

Recovery and Pain

  • Scar and swelling massage
  • Ice and compression therapy like Game Ready
  • Interferrential if preferred

If you've got an elbow condition and don't know what to do, contact Dr Gupta on 02 9687 8344 or make an online booking here.