Note: This pathway is designed to serve as a guide to rehabilitation. Indications for progression should be based on patient’s complete operative procedure, functional capacity and response to treatment.

Days 10-21:

  • Elbow AAROM –> AROM into flexion and extension with elbow at side (adducted). No extension in supinated position.
  • Shoulder, wrist/hand AROM/gentle strengthening with considerations of elbow involvement.

Goals

  • Edema and pain control, wound care.
  • Maintain AROM / prevent stiffness of cervical spine/shoulder/wrist/hand.
  • Maintain integrity of repair including prosthesis, ligaments, tendons involved. Avoid supinated extension and any values forces on the elbow.
  • 30-105 degrees elbow ROM by day 21.

Weeks 3-6:

  • Continue AROM/exercises at surrounding joints.
  • Continue AROM exercises at the elbow for flexion and extension.
    • Begin gradual isotonic strengthening into elbow flexion and extension.
  • Begin AAROM –> AROM into pronation and supination.

Goals:

  • Edema and pain control.
  • Prevent stiffness of surrounding joints.
  • Near full flexion / extension ROM by week 6.
    • Full extension typically more challenging to recover.

Weeks 7-12:

  • Continue AROM/exercises at surrounding joints.
  • Continue progression of AROM / isotonic strengthening exercises at the elbow for flexion, extension, pronation and supination.
  • Address remaining deficits.

Goals:

  • Prevent stiffness of surrounding joints.
  • Full pronation/supination ROM by end of week 8.
  • Regain full pain-free ROM and return to prior level of function.