From the Research
The treatment protocol after arthroscopic capsular release surgery should prioritize a comprehensive rehabilitation program starting immediately post-operation, focusing on pain management, passive range of motion exercises, and progressive strengthening to optimize outcomes and minimize complications, as supported by the most recent and highest quality study 1. The goal of this rehabilitation program is to maintain the mobility gained during surgery, reduce pain and inflammation, and prevent the formation of new adhesions. Key components of the program include:
- Pain management using NSAIDs like ibuprofen (400-600mg every 6-8 hours) or naproxen (500mg twice daily) for 1-2 weeks, along with prescribed opioids such as hydrocodone/acetaminophen (5-10mg/325mg every 4-6 hours as needed) for breakthrough pain in the first few days.
- Physical therapy starting within 24-48 hours after surgery, focusing initially on passive range of motion exercises, such as pendulum exercises, wall slides, and passive stretching, 3-5 times daily for 5-10 minutes each session.
- Progression to active-assisted exercises in weeks 2-3, adding light resistance training by weeks 4-6, as shown to be effective in improving functional outcomes and reducing pain 1.
- Use of continuous passive motion machines in the immediate post-operative period to prevent adhesion formation, and cryotherapy with ice packs for 15-20 minutes every 2-3 hours to reduce inflammation and pain.
- A recent study 1 demonstrated that patients with idiopathic frozen shoulder had better functional outcomes after arthroscopic capsular release, highlighting the importance of considering etiology in treatment planning.
- Another study 2 suggested that less extensive releases may result in better functional and pain scores, and that the addition of a posterior release offers increased early internal rotation, which was not sustained over time, but provides early and sustained flexion improvements. Overall, the treatment protocol after arthroscopic capsular release surgery should be tailored to the individual patient's needs and etiology, with a focus on aggressive early mobilization and progressive strengthening to optimize outcomes and minimize complications, as supported by the most recent and highest quality evidence 1.