Post op
Day 1 – 3 weeks
- External Rotation brace for 3 weeks (can remove for washing and exercise; wear on outside of or under clothes)
- Encourage circulation exercises during this time
- Finger / wrist / elbow exercises
- Teach postural awareness and scapular setting
- Active assisted ROM as comfortable
- Core stability exercises with sling
- No combined forward flexion and Internal rotation exercises
- Do not force or stretch
3-6 weeks
- Sling to be removed 4x a day
- Progress Active assisted to Active ROM as comfortable
- No combined forward flexion and Internal rotation exercises
- No active or passive internal rotation
- Assisted/ active external rotation to 20 degrees
- Isometric external rotation exercises
- Work to gain activity and stability of rotator cuff
- Work on scapula control
- Commence proprioceptive exercises (minimal weightbearing below 90 degrees)
- No hand across the body or behind the back activities
6 weeks – 4 months:
The sling is removed by 6 weeks
- After 2 months any residual tightness to internal rotation may be addressed by specific stretching exercise
- Regain scapula & glenohumeral stability working for shoulder joint control rather than range
- Gradually increase ROM
- Strengthen – sports specific
- Increase proprioception through open & closed chain exercise
- Progress core stability exercises
ACTIVITIES:
Driving at 8-10 weeks if patient feels safe to do so.
Swimming – Breaststroke at 10-12 weeks.
Running at 10-12 weeks. Return to light work by 8-10 weeks.
No other sports yet.
| Milestones | |
| Week 6 | Active elevation to pre op level |
| Week 12 | Minimum 80% range of internal rotation compared to asymptomatic side Normal movement patterns throughout range |
| Failure to achieve milestones | Referral to surgeon |