This protocol is intended to be a general guideline. The physician staff may advance, delay, or alter this protocol based on individual patient status. If so, this should be done by direct communication with the therapist, or in writing on the therapy referral form provided to the patient or therapist. 

This protocol should be modified to incorporate functional milestones for individual patient goals as indicated.

Guidelines for MD Follow-Up Visits (including telehealth)

  • At two weeks post-op, patient will be seen in clinic for removal of stitches and follow up.
  • At six weeks post-op, patient may be seen by physician extender through telehealth video communication during an in-clinic PT session to connect with patient and treating therapist and discuss current ROM and strength status. 
  • Additional follow-ups with MD and physician extender staff will be scheduled as needed.

Guidelines for Wound Care

  • Original steri-strips should be left in place until stitch removal. They can be reinforced with more steri-strips if needed.  
  • On Day One post-op, patient can remove bulky post-op cotton and gauze dressings. Patient will be instructed to wrap shoulder in “press and seal” plastic wrap for showering until 3-5 days after stitches are removed (make sure wounds are fully healed before being exposed to water). 

Week 0-2 Post-Op: General Guidelines for At-Home Recovery

Precautions: No external rotation beyond 0°

Goals: Decrease pain, allow minimal passive motion. Patient should wear immobilizer sling for first 4 weeks, or as directed by physician. Patient will not be seen in PT unless directed by physician.

  • Patient may use cryotherapy several times a day for pain and inflammation control
  • Emphasis on use of abduction sling, HEP compliance, and adequate use of pain medication and other modalities to control pain
  • Starting on the day of surgery, patient will perform the following exercises as instructed by physician or ancillary staff: Codman’s pendulum exercises, shoulder shrugs, scapular retraction, scapular depression, elbow curls without weight, and grip strengthening
  • One week after surgery, patient may begin light aerobic exercise (bike, walk) while wearing sling for cardiovascular fitness

Phase I (Week 2