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.
0-1 Weeks Post-Op: General Guidelines – 1 visit
Precautions: Protect the subscapularis, bony union of the coracoid, biceps and coracobrachialis. No aggressive shoulder extension or ER for the first 6-8 weeks. No AROM or PROM of shoulder.
- Minimize shoulder pain, decrease inflammation, protect repair.
- Patient should wear Ultrasling with abduction wedge for first 6-8 weeks.
- AAROM bicep curls without weight, and AROM grip strengthening. These should be performed supine in gravity-eliminated position with the shoulder in neutral.
- One week after surgery, patient may begin light aerobic exercise (bike, walk) while wearing sling for cardiovascular fitness
- Ice for several times/day for pain and inflammation control
Week 1-6: Patient seen 2-3 visits/week
Precautions: No AROM. No excessive ER (stop at end feel). No lifting, pushing, or pulling. Prevent shoulder extension with pillow behind elbow in supine.
Goals: Minimize shoulder pain, decrease inflammation, protect repair. There should be minimal to no pain with exercises.
PROM Goals by end of Week 6: 100° flexion, 30° ER, 45° IR, 30° abduction.
- Continue use of Ultrasling with abduction wedge. Discontinue at 6 weeks.
- Continue elbow curls without weight and ball squeezes for circulation
- Begin supported pendulum exercises, shoulder shrugs, scapular retraction, scapular depression, and lawnmowers
- Supine PROM for flexion to tolerance. ER to 30 degrees in 30 degrees of abduction. IR to 45 degrees in 30 degrees of abduction in all scapular planes.
- Cane exercises for AAROM flex and ER
- At Week 2, begin pulley exercises for additional AAROM in planes of flexion to tolerance, and AAROM scaption to 30 degrees.
- At Week 6, submaximal (20-50% effort) isometrics for shoulder musculature in standing or supine
Week 6-10: Patient seen 2-3x/week
Precautions: No Pushing Pulling or lifting. No excessive
Goals: Protect r