Protective Phase (0-6 weeks post-operative):

  • Minimize pain.
  • Allow for soft tissue healing.
  • Improved neuromuscular control and volitional activation of periscapular muscles.
  • Limit PROM/AAROM flexion-90, ABD-90, IR-45, ER-45 in neutral.
  • No shoulder AROM until 6 weeks, no RROM until 8 weeks.
  • No lifting, sudden movements or supporting of body weight with hand.
  • Wear sling as recommended by physician. Remove for rehab or bathing.
Rehab to include:
  • Shoulder PROM/AAROM flexion, ABD, IR, ER (rotation 0-45 ABD)
  • AROM/RROM hand, wrist, elbow
  • Gentle IR behind back
  • Isometric scapular retraction/depression

Intermediate Phase (6-8 weeks post-operative):

Discontinue sling at 6 week follow up with Dr. LaFrance.

  • Painless PROM/AAROM/AROM flexion-140, ABD-120, IR-70, ER-90 (rotation at 90 ABD) IR behind back to T10.
  • Limit PROM/AAROM/AROM flexion 140, ABD 120.
  • No shoulder RROM until 8 weeks.
  • No lifting objects.
Rehab to include:
  • RROM hand, wrist.
  • Continue with persiscapular isometrics.
  • Initiation of sub-maximal shoulder isometric IR/ER/ABD/Flex/Ext in GH neutral.
  • Initiate shoulder AROM all planes starting in gravity lessened positions and progress against gravity as tolerated within restrictions.

Initial Strengthening Phase (8-12 weeks):

  • Obtain Full PROM/AROM
  • 4+/5 RC, scapular stabilizers
  • No heavy lifting especially above shoulder level
Rehab to include:
  • Full PROM/AAROM/AROM all planes
  • RROM rotator cuff shoulder flexion, ABD, IR/ER, scaption.
  • Endurance training (UBE).
  • Scapular stabilization RROM and progress rhythmic stabilization.

Advanced Functional Strength Phase (12 weeks-on):

  • Strengthen and further stabilize RC and scap stabilizers.
  • Independent long-term HEP.
  • Return to normal function and sports activities.
Rehab to include:
  • RROM Rotator cuff and periscapular strengthening progressing to functional positions.
  • Plyometrics progression.
  • Sport specific, work specific training.