Latissimus / Teres Major Repair Post-op Protocol
This 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.
General Post-Operative Guidelines
- Wounds to be kept dry using steri–strips and occlusive dressing, changed as needed to maintain dry peri-wound area
- Ultrasling: Patient should wear sling with wedge for all ADL’s and sleeping. May remove wedge and wean off sling at Week 6.
Week 0 – 1: Patient not seen in clinic
Precautions: No AROM of the shoulder
- Wear immobilizer sling with wedge for all activities except hygiene
- Patient to do home exercises as given post-op: pendulums, elbow AROM, wrist AROM, grip strengthening
Week 1 – 6: Patient seen 3x/week
Precautions: PROM ONLY
No AROM or AAROM of the shoulder (no cane assisted ROM).
No resisted shoulder activity for 12 weeks post op.
No cane/pulley AAROM until 6 weeks post-op
ROM Guidelines: PROM flexion to 90°, ER 30°, abd 60° without rotation
- Supine GENTLE PROM only for flexion, scaption, ER, and IR
- Soft tissue mobilization (parascapular, cervical) as indicated
- Heat before Rx, cold after Rx as indicated
Week 6-12: Patient seen 2x/week or as indicated
Precautions: No resistance until ROM is full
- Continue above exercises
- Light passive stretching at all end-ranges of shoulder ROM
- Progress shoulder to AAROM and then AROM as tolerated