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Rehabilitation Protocol

Posterior Capsulolabral Reconstruction (Arthroscopic)

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.
  • Brace should be in place when not performing exercises.
  • May start active scapular mobility exercises at 3 to 4 weeks – Must keep the shoulder musculature relaxed.
  • Avoid IR ROM and flexion greater than 90.
  • Initiate exercise program 3 times per day:
    • Immediate elbow, forearm and hand range of motion
    • Passive and active assistive ER at the side to 60, scapular plane abduction to 90, flexion to 90 only

Phase II: Progress ROM and protect repair (6 to 12 weeks)

  • May discontinue brace.
  • Lifting restriction of 5 pounds with the involved extremity.
  • Initiate gentle rotator cuff strengthening.
  • Continue scapular stabilizer strengthening.
  • Avoid IR in abducted position > 30 and cross body shoulder motion
  • Advance active and passive ROM:
    • ER at the side and scapular plane elevation to tolerance
    • Flexion to tolerance – shouldershould be in externally rotated position
    • Extension to tolerance
    • IR from abducted position to 30 degrees

Phase III: Full function (> 3 months)

  • Begin combined full flexion and IR from abducted position.
  • 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