Accessibility Tools

Rehabilitation Protocol

Phase I: Protect repair (0 to 6 weeks)

  • May remove dressing and shower postop day #3.
  • Sutures are all underneath the skin and will dissolve on their own.
  • Ice or cold flow systems encouraged for the first week at a minimum: should be used 3-4 times per day.
  • Sling should be in place when not performing exercises.
  • Initiate exercise program 3 times per day:
    • Immediate elbow, forearm and hand range of motion out of sling
    • Pendulum exercises
    • Passive and active assistive ER at the side to 30, flexion to 130, true glenohumeral scapular plane abduction 90
  • May start active scapular mobility exercises at 3 to 4 weeks – Must keep the shoulder musculature relaxed.
  • Isometrics starting 4 weeks
  • Avoid range of motion into abduction, ER >30 degrees or active IR

Phase II: Progress ROM & Protect Repair (6 to 12 weeks)

  • May discontinue sling.
  • Lifting restriction of 5 pounds with the involved extremity.
  • Advance active and passive ROM:
    • ER at the side and flexion to tolerance
    • Scapular plane elevation to 130
    • IR and extension to tolerance
  • Initiate gentle rotator cuff strengthening.
  • Continue scapular stabilizer strengthening.
  • Avoid combined abduction and ER ROM, active or passive.

Phase III: Full function (>3 months)

  • Begin combined abduction and ER ROM and capsular mobility.
  • Discontinue lifting restrictions.
  • Advance rotator cuff and scapular stabilizer strengthening.
  • Initiate functional progression to sports specific activities at 4 months.
  • American Academy of Orthopaedic Surgeons
American Shoulder and Elbow Surgeons
  • New England Shoulder and Elbow Society
  • Boston Sports & Shoulder Center
  • Tufts University