| Time | Day 0 | 0–2 weeks | 2–4 weeks | 4–6 weeks | 6–12 weeks | 12+ weeks |
| Immobilisation & Protection | Elbow often placed in a posterior splint or extension brace for 10–14 days. Use sling for comfort. | Splint removed (~2 weeks); commence elbow ROM; continue sling as needed. | Sling discontinued; focus on gentle elbow motion; protect wound. | No brace. Continue protection (no heavy use). | Unrestricted use within pain-free limits. | Full activity with lifelong precautions (weight limits). |
| Mobilisation/ Exercises | Hand/wrist/shoulder exercises and gentle elbow motion in splint if allowed. | Begin active-assisted and active elbow flexion/extension and forearm rotation (supination/pronation) as tolerated[10]. Avoid heavy effort. | Increase elbow ROM aiming for full flexion/extension. Begin gentle isometric strengthening of shoulder/scapula. | Progress elbow active ROM. Begin light flexor/extensor isometrics around 6 weeks. | At ~8–12 weeks, initiate progressive resistive exercises (but use limb weight only – e.g. gravity-based curls). | Ongoing strengthening; caution with heavy lifting. |
| Activity | Immobilised arm elevated. No weight-bearing. | Light hand activities; no pushing/pulling with operated arm. No driving. | Light ADLs permitted (e.g. eating, grooming) within limits (avoid opening heavy doors). | Gradually start functional use (e.g. carrying light objects <1–2 kg). Drive when comfortable (~4–6 weeks). | Most ADLs allowed; avoid repetitive heavy lifting. Gentle aerobic exercise resumes. | Return to normal daily life; permanent weight lifting restrictions apply. |
Key clinical points: Early motion is encouraged but with strict weight restrictions. No weight-bearing on the elbow for at least 6–8 weeks (e.g. do not push up from a chair). Elbow flexion/extension and pronation/supination ROM should be regained gradually after splint removal. Strengthening is very gradual: initially only gravity-assisted and submaximal isometrics, avoiding resistance until ~8–12 weeks. Surgeons commonly advise lifelong lifting limits (often 2–5 kg) to protect the prosthesis.
Movement restrictions: Avoid heavy or repetitive lifting ever. No resistive elbow flexion/supination for at least 6 weeks. Avoid pushing up from chair or using arm to lift body weight for ~3 months.
Return to function: Sedentary desk work by ~4–6 weeks (with arm in sling initially). Manual/light work at ~3–4 months (with restrictions). No return to heavy lifting or contact sports; hiking/cycling possible after 6–12 weeks with care.
