Shoulder Balloon Implant (InSpace Balloon)

Physical Therapy Protocol

Phase I – Protection Phase (Day 1 to Week 4)

Precautions:

• Wear sling continuously (day and night); remove only during exercises or therapy.
• No sudden, quick, or repetitive movements.
• Avoid lifting, pushing, or using the arm against resistance.
• Do not drive until safely able to operate a vehicle with both hands.
• Avoid any activity that risks displacing the balloon spacer.

Goals:

• Reduce pain and inflammation.
• Maintain mobility in surrounding joints (scapula, neck, elbow, wrist, hand).
• Initiate safe, pain-free ROM within protocol limits.

Therapeutic Guidelines:

• Use modalities as needed: ice, IFC, etc.
• Begin PROM and AAROM within comfort range.
• Flexion and abduction limited to 0–60 degrees.
• Include pendulum exercises, scapular mobility, cervical spine mobility.
• Activate grip, wrist, elbow, and forearm with gentle AROM.
• Begin gentle shoulder rotation (must be pain-free and controlled).

Phase II – Transition Phase (Weeks 4 to 6)

Precautions:

• Discontinue sling use at 4 weeks unless needed for comfort or sleeping.
• Continue to avoid heavy lifting and rapid arm movements.

Goals:

• Gradually restore functional ROM without pain.
• Encourage independence in daily shoulder exercises.

Therapeutic Guidelines:

• Continue PROM/AROM with gradual stretching.
• Progress frequency and range as tolerated.
• Exercises may be performed independently or with therapist assistance.
• Emphasize pain-free, steady movement.

Phase III – Strengthening Phase (Weeks 6 to 12)

Precautions:

• Temporary discomfort or transient pain is expected.
• Avoid any forceful or resisted arm movement.

Goals:

• Regain preoperative ROM or show weekly improvements.
• Begin gentle strengthening of deltoid and scapular stabilizers.

Therapeutic Guidelines:

• Progress daily ROM and stretching routines.
• Begin pain-free isometric strengthening (e.g., deltoid activation).
• Gradually increase exercise volume and control.

Phase IV – Return to Activity Phase (Weeks 12+)

Goals:

• Return to preoperative activity levels as tolerated.
• Normalize shoulder strength and functional mobility.

Therapeutic Guidelines:

• Continue rehab activities up to 6 months as needed.
• Introduce functional movements and gentle resistance activities.
• Delay overhead or dynamic resistance tasks until cleared by the surgeon.