PHYSICAL THERAPY PROTOCOL
Capsular Release
Physical Therapy Protocol
Rehabilitation following arthroscopic capsular release is focused on one primary goal: maintaining the motion gained during surgery. Physical therapy begins immediately after surgery and should be performed aggressively enough to prevent recurrent stiffness while maintaining patient comfort.
Begin Therapy
Maintain Motion
Strengthening
Prevent Recurrent Stiffness
Important Note
Unlike many shoulder procedures, rehabilitation following capsular release should begin immediately. Delayed therapy significantly increases the risk of recurrent stiffness. Therapy frequency may be adjusted based on individual progress, but maintaining motion is the highest priority during the first several weeks.
Rehabilitation Philosophy
The purpose of surgery is to restore shoulder motion that could not be regained with conservative treatment. Surgery alone does not cure frozen shoulder. The motion achieved during surgery must be maintained with frequent stretching and supervised physical therapy. Early commitment to rehabilitation is the single most important factor influencing the final outcome.
Phase I: Immediate Motion
Timeframe: Day 1 through Week 6
Goals
- Maintain intraoperative range of motion
- Prevent recurrent scar formation
- Control pain and swelling
- Restore functional shoulder use
- Normalize scapular motion
Sling
- Sling for comfort only
- Discontinue as soon as possible
- Encourage frequent shoulder motion throughout the day
- Avoid prolonged immobilization
- Use the arm for light daily activities as tolerated
Therapy
- Begin physical therapy within 24 hours of surgery
- Daily home stretching program
- Frequent passive stretching
- Active-assisted range of motion
- Active range of motion
- Joint mobilization as indicated
Exercises
- Pulleys
- Table slides
- Wall walks
- Cane-assisted stretching
- Posterior capsule stretching
- Cross-body stretching
- External rotation stretching
- Internal rotation stretching
Phase II: Motion And Strength
Timeframe: 6–12 Weeks
Goals
- Maintain full motion
- Restore strength
- Normalize shoulder mechanics
- Improve endurance
Exercises
- Theraband strengthening
- Rotator cuff strengthening
- Scapular strengthening
- Light dumbbell strengthening
- Closed-chain stabilization
- Continue daily stretching
Phase III: Return To Activity
Timeframe: 12+ Weeks
Strength
Continue progressive strengthening while maintaining full motion.
Function
Return to unrestricted work, recreation, and sports as tolerated.
Maintenance
Continue a stretching program until motion has completely stabilized.
Return To Activity Guidelines
Desk Work
Usually within several days.
Driving
When comfortable and no longer taking narcotic medication.
Daily Activities
Immediately as tolerated with frequent shoulder motion encouraged.
Golf
Resume as comfort and motion permit, often by 6–8 weeks.
Weight Training
Progress once motion has been restored and strengthening has begun.
Sports
Return after restoration of full motion, strength, and confidence.
Therapist Notes
- Physical therapy should begin within 24 hours of surgery.
- The greatest risk is recurrent stiffness—not instability.
- Motion should be emphasized over protection.
- Encourage multiple stretching sessions throughout the day.
- Continue stretching even after strength returns.
- Contact the office promptly if motion begins to decline.
Red Flags
Contact The Office For
- Increasing pain after initial improvement
- Loss of previously regained motion
- Increasing redness or drainage
- Persistent swelling
- Difficulty participating in therapy
Seek Urgent Care For
- Chest pain
- Shortness of breath
- Calf pain or swelling
- Severe uncontrolled pain
Related Resources
Questions About Capsular Release Rehabilitation?
Maintaining motion after surgery is the key to a successful outcome. Early therapy, frequent stretching, and consistent participation in a home exercise program provide the best chance of restoring normal shoulder function.
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