Anterior Shoulder Stabilization Rehabilitation Program

PHASE I: 1-3 WEEKS POST-OP

Range Of Motion

PROM

  • Flexion: 90°
  • Abduction: 90°
  • ER: 30°
  • IR: to belly

Sling

  • Immobilized in sling with abduction pillow at all times, may be removed for exercises and showering. Wear sling at night.

Therapeutic Exercise

  • Codman’s Pendulums
  • Cervical ROM
  • Begin scapula musculature isometrics / sets
  • Elbow, wrist, hand ROM
  • Ball squeezes
  • General conditioning: bike, treadmill, etc.
  • No AROM or AAROM

PHASE II: 3-6 WEEKS POST-OP

Range Of Motion

  • Gradually increase Flexion / Extension to 80% of uninjured extremity
  • Continue to limit ER and abduction – No ER past 90° in 90° of abduction

Sling

  • Sling for comfort Week 3-4
  • Transition out of sling Week 4

Therapeutic Exercise

  • Begin AAROM exercises
  • Pulley exercises
  • Continue pool therapy if available
  • Begin gentle rotator cuff isometric strengthening (ER at neutral)
  • Periscapular strengthening
  • Core strengthening
  • Supine AAROM

PHASE III: 6 - 12 WEEKS POST-OP

Range Of Motion

  • Progress to near full ROM (except abduction/external rotation)
  • Continue to limit ER and abduction – No ER past 90° in 90° of abduction

Sling

  • None

Therapeutic Exercise

  • Begin AROM exercises
  • Joint Mobilizations
  • Rotator Cuff isometrics
  • Elastic Resistance: ER/IR with elbow at the side of the body, forward punch, seated row, shoulder shrug, seated row, bicep curls, lat pulls, tricep extensions
  • Gentle strengthening overhead: ER/IR in 90/90, D1/D2 flexion and extension diagonals

PHASE IV: 12-16 WEEKS POST-OP

Range Of Motion

  • Progress to full ROM without discomfort

Sling

  • None

Therapeutic Exercise

  • Continue stretching and strengthening with resistance bands
  • Can begin golf, tennis (no serves until 4 months)
  • Progress free weight exercises (low weight, high reps)
  • IR/ER: sidelying
  • Supraspinatus: scapular plane
  • Shoulder flexion: through pain free range of motion
  • Arm ergometer/cycle for endurance exercise

PHASE V: 16+ WEEKS POST-OP

Range Of Motion

  • Full ROM without discomfort

Sling

  • None

Therapeutic Exercise

  • Begin practicing skills at a low intensity level for specific sport
  • For throwers, initiate a throwing program
  • Tennis may begin serves
  • Total body conditioning/ergometer cycle

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