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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.
  • May start active scapular mobility exercises at 4 weeks – Must keep the shoulder musculature relaxed.
  • Strict ROM restrictions
  • Initiate exercise program 3 times per day:
    • Immediate elbow, forearm and hand range of motion out of sling
    • Pendulum exercises
    • Emphasize home program (instruct family member with ROM)
    • Passive and active assistive ER at the side to 30, flexion and scapular plane elevation to 90 only

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

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

Phase III: Full Function (>3 months)

  • Begin combined abduction with ER and IR ROM and advance capsular mobility (gently).
  • 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