Phase 1 (0-7 days post-op)
- Posterior splint elbow extended.
- Wrist and hand gripping exercises.
Phase II (1 week through 6 weeks post-op)
- Post op brace locked when not working on therapy exercises.
- No formal physical therapy needed during this phase.
- May unlock brace 3-4 times daily for passive elbow extension and active assisted elbow flexion up to 70 degrees.
- No active elbow extension.
- Shoulder PROM, AAROM, and AROM as tolerated in all planes.
- Scapular retraction and shoulder shrugs.
- Active wrist flexion, extension, pronation and supination.
- Gripping exercises.
Phase III (6 weeks post-op)
- Begin active elbow extension.
- Begin sub-maximal co-contraction exercises of biceps and triceps.
- Elbow flexion PROM to progress as follows.
- 6 weeks: PROM to 70 degrees.
- 7 weeks: PROM to 90 degrees.
- 8 weeks: PROM to 110 degrees.
- 9 weeks: PROM to 130 degrees, etc.
- Full elbow flexion achieved by approximately 12 weeks post-op.
- Begin light elbow flexion with resistance within allowed range.
- Full shoulder active range of motion.
- Active scapular retraction and resisted rotator cuff program.
Phase IV (12 weeks post-op)
- Triceps light isotonics progressing 1 pound per week begin at week 12.
- Initiate UBE.
Phase V (16 weeks post-op)
- Progressive strengthening as tolerated.
- Functional progression to athletic activity.
- Return to full participation in athletic activity at 5 months post-op.
