Arthroscopic Capsular Release and Manipulation Under Anaesthesia. Stage 1 – Physiotherapy and Exercise

This leaflet informs you about stage 1 post-operative exercises and advice following an arthroscopic capsular release or a manipulation under anaesthesia.

Before you are discharged, a member of the inpatient therapy team will guide you through the exercises. They will provide you with advice and answer any questions you may have.

You will then be contacted by the outpatient physiotherapy team, who will provide you with further advice and exercises to aid in your recovery.

For how long should I wear my sling?

The sling provided is used for comfort and should be discarded once the nerve block has fully worn off. Do not remove the sling until you have full feeling back in your arm. This usually takes between 12 – 48 hours.

Once you have removed the sling, you can use your shoulder as normally as comfort allows and start your exercises as shown.

What can I do to help myself?

It is very important to get as much movement back in your shoulder as soon as you can. This will mean you can start to use your shoulder normally and perform your daily functions.

Managing your pain and doing your exercises every day will help this to happen quicker. If you require it, pain relief can be useful to help minimise any pain and give you the confidence to exercise and use your shoulder.

If you have been given pain relief, you should take it as prescribed. You should always read the label if using over-the-counter medication. If you are in any doubt, speak to your pharmacist or GP. If your pain becomes severe or is continuous, you should contact your GP.

What exercises should I do following my surgery?

You should aim to perform the following exercises 3 times a day. Perform 10 repetitions, have a rest for 1 minute and repeat a further 10 times.

It is normal for you to feel aching, discomfort or a stretching feeling when doing these exercises. If you experience intense and lasting pain (e.g., it lasts more than 30 minutes) do it less forcefully or less often. If this does not help, discuss the problem with the Physiotherapist.

Exercise 1: Seated Table Slides

While sitting, rest your hands on a table. Using a duster or similar object, slide your hands away from your body as far as comfortable and then return to the start position.

Shoulder flexion

Two examples have been provided. Try both exercises and find the one that is most comfortable for you and perform that one.

Exercise 2a: Shoulder Flexion

Lay on your back with your knees bent and feet flat. use head support if need.

Note: If you are unable to lay flat, you can perform the exercises while sitting, high lying with pillows for support or while standing.

Hold a stick or similar object with hands at shoulder-width apart. Starting with the stick resting on your thighs, lift the stick with straight arms. Return to the start position.

Exercise 2b: Shoulder Flexion

Stand in front of a high table, place both hands on top of the table. Walk backwards away from the table, as far as you are comfortably able to. Leave your hands supported on the table, allowing your shoulders to flex. Walk forwards, returning to the start position.

Exercise 3: Shoulder Abduction

Lay on your back with knees bent and feet flat. Use head support if needed.

Note: If you are unable to lay flat you can perform these exercises in sitting, high lying with pillows for support or while standing.

Hold a stick or similar object with hands at shoulder-width apart. With the unaffected arm, push the stick moving the operative arm away from the body in a diagonal movement up and out to the side. Return to the start position.

Exercise 4: Shoulder External Rotation

In sitting, place a towel roll between your elbow and body.

Keeping your elbow bent at 90 degrees as in the above images.

Hold a stick or similar object in your hands, use your unaffected arm to help rotate your operated arm as far as you can, and return to the start position.

Contact numbers

Upper Limb Secretary
Monday to Friday
09:00am-05:00pm
Telephone: 01642 624442

Physiotherapy Appointment Queries
Monday to Friday
09:00am-05:00pm
Telephone: 01429 522471

Ward 32/33
24 hours a day, 7 days a week
Telephone: 01642 382832
Telephone: 01642 382732

Leven Unit
Monday- Thursday 07:00am-08:00pm
Friday 07:00am-07:00pm
Telephone: 01642 383832

Other useful links

North Tees and Hartlepool NHS Foundation Trust

Upper Limb (Shoulder, elbow, hand and wrist surgery) – patient information.
Website: https://www.nth.nhs.uk/services/trauma-orthopaedics/upper-limb/

A video version of the leaflet was developed to demonstrate the individual exercises. The video can be viewed using the link below:
https://www.nth.nhs.uk/services/trauma-orthopaedics/upper-limb/post-op-physiotherapy/

References

• Hachard. N.C.A., Goodchild,L., Brealey,S.D.,Lamb, S.S and Rangan, A. (2020). Physiotherapy for primary frozen shoulder in secondary care: developing and implementing stand-alone and post operative protocols for UK FROST and inferences for wider practice. Physiotherapy. [Online] 107, PP. 150 -160.

• Pictures supplied by Physio tec. Accessible at: https://physiotec.ca/ca/en/

Comments, concerns, compliments or complaints

Patient Experience Team (PET)

We are continually trying to improve the services we provide. We want to know what we’re doing well or if there’s anything which we can improve, that’s why the Patient Experience Team (PET) is here to help. Our Patient Experience Team is here to try to resolve your concerns as quickly as possible. The office is based on the ground floor at the University Hospital of North Tees if you wish to discuss concerns in person. If you would like to contact or request a copy of our PET leaflet, please contact:

Telephone: 01642 624719

Freephone: 0800 092 0084

Opening hours: Monday to Friday, 9:30am to 4:00pm

Email: [email protected]

Out of hours

Out of hours if you wish to speak to a senior member of Trust staff, please contact the hospital switchboard who will bleep the appropriate person.

Telephone: 01642 617617

Data protection and use of patient information

The Trust has developed Data Protection policies in accordance with Data Protection Legislation (UK General Data Protection Regulations and Data Protection Act 2018) and the Freedom of Information Act 2000. All of our staff respect these policies and confidentiality is adhered to at all times. If you require further information on how we process your information please see our Privacy Notices.

Telephone: 01642 383551

Email: [email protected]

Leaflet feedback

This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Clinical Governance team, North Tees and Hartlepool NHS Foundation Trust, University Hospital of North Tees, TS19 8PE or:

Email: [email protected]

Leaflet Reference: PIL1283
Date for Review: 28/11/2025