his protocol is intended to be a general outline only. The physician reserves the right to either advance or delay this protocol as deemed necessary. If so, this should be done by direct communication with the therapist, or in writing on the therapy referral form given to the patient on the day of surgery.


0-4 Weeks Post-Op: Patient to be seen 2-3x/week


  • No isolated biceps activation
  • Use of Ultrasling 4 weeks
  • No use of operative arm for lifting, pushing or pulling of objects
  • Keep incisions clean and dry until told by physician to get wet
  • No massage directly over operative area
  • Ice several times/day for control of pain and inflammation


Decrease pain, protect repair.  Achieve gradual PROM – prohibit elbow hyperextension or overstretching.  Promote scapular mobility


At Week 1: 

  • Pendulum exercises, shoulder shrugs, scapular retraction, scapular depression.
  • PROM elbow flexion/extension, wrist supination/pronation, AROM hand exercises (ball squeezes).
  • Begin light aerobic exercise (bike, walk) while wearing sling for cardiovascular fitness.


At Week 2:

  • Shoulder pulley exercises for AAROM in planes of flexion and scaption
  • PROM all shoulder planes, within pain tolerance
  • Scapular isometrics, lawnmowers, table lifts


At Week 4: 

Discontinue Ultrasling.

  • Submaximal (50% effort) isometrics for shoulder musculature in standing or supine and progress.
  • Scapular mobilization in sidelying to promote proper scapulohumeral rhythm
  • Prone shoulder retraction and extension to neutral
  • Core strengthening exercises as indicated to promote proximal stability
  • Scar massage once wound is healed to avoid adhesions.


Week 5-9: Patient seen 2-3x/week

Precautions: NO lifting, pushing, or pu