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Arthroscopic Shoulder Stabilization Rehab

PHASE I - IMMEDIATE POST-SURGICAL PHASE (DAYS 1 - 14)

Goals:

  • Maintain integrity of the repair
  • Diminish pain and inflammation
  • Prevent muscular inhibition

Days 1-14

  • Sling
  • Elbow/hand gripping & ROM exercises
  • Cryotherapy/Ice for pain and inflammation - 15-20 minutes every hour
  • Sleeping - sleep in sling or brace

Precautions to be maintained through Week 6:

  • Maintain arm in brace, remove only for exercise
  • No lifting of objects
  • No excessive shoulder extension or external rotation
  • No excessive or aggressive stretching or sudden movements
  • No supporting of body weight by hands
  • No bimanual activities (pulling on pants/socks, etc.)

PHASE II - PROTECTION PHASE (WEEKS 3 - 6)

Goals:

  • Allow healing of soft tissue, protect repair
  • Gradually restore full PROM by Weeks 4 - 6
  • Re-establish dynamic shoulder stability
  • Decrease pain & inflammation
  • To achieve near full PROM by week 7

Weeks 3-4

  • Continue pendulum exercises
  • Continue use of cryotherapy/ice as needed if still swollen
  • Depending upon repair/tissue/pathology may begin gentle PT
  • Staged Passive Range of Motion (PROM)
    • Passive Forward Elevation (PFE): 90°
    • Passive External Rotation (PER) @ 20° abd: 10 – 30°
    • Passive External Rotation (PER) @ 90° abd: Contraindicated
    • Active Forward Elevation (AFE): N/A

Weeks 5-6

  • May remove sling at home but should keep on while sleeping or in community
  • Start formal PT around weeks 5 – 6 if not already begun
  • Pendulum exercise
  • PROM/AAROM exercise
    • Passive Forward Elevation (PFE): 135°
    • Passive External Rotation (PER) @ 20° abd: 35 – 50°
    • Passive External Rotation (PER) @ 90deg; abd: 45deg;
    • Active Forward Elevation (AFE): N/A
  • Submaximal rotator cuff (RTC) isometrics

PHASE III - INTERMEDIATE PHASE (WEEKS 7 - 12)

Goals:

  • Maintain staged ROM goals to normalize PROM/AROM. DO NOT EXCEED!
  • Minimize pain
  • Increase strength and endurance
  • Increase functional activities

Weeks 7-8

  • Discontinue sling
  • Continue PROM/AAROM/AROM (as needed to maintain staged ROM)
    • Passive Forward Elevation (PFE): 135o
    • Passive External Rotation (PER) @ 20° abd: 35 - 50°
    • Passive External Rotation (PER) @ 90° abd: 45°
    • Active Forward Elevation (AFE): 115°
  • Work on scapulo-humeral rhythm, peri-scapular strengthening (no push-ups plus)
  • May use arm for light activities of daily living (ADL's)
  • May begin gentle AROM
  • Gentle core strengthening

Weeks 9-12

  • Continue PROM/AAROM/AROM (as needed to maintain staged ROM)
    • Passive Forward Elevation (PFE): 155o
    • Passive External Rotation (PER) @ 20° abd: 50 - 65°
    • Passive External Rotation (PER) @ 90° abd: 75°
    • Active Forward Elevation (AFE): 145°

PHASE IV - ADVANCED STRENGTHENING PHASE (WEEKS 13 - 24)

Goals:

  • Maintain full non-painful ROM
  • Enhance functional use of upper extremity
  • Improve muscular strength & power
  • Gradual return to functional activities

Weeks 13-19

  • Continue ROM & gentle stretching to maintain full ROM
  • Self capsular stretches
  • Progress shoulder strengthening exercises

PHASE V - RETURN TO ACTIVITY PHASE (WEEKS 24+)

Goals:

  • Gradual return to strenuous work activities
  • Gradual return to recreational sport activities

Week 24

  • Continue stretching, if motion is tight
  • May initiate interval sport program (i.e., golf, etc)

Please use the link provided to learn more about arthroscopic shoulder stabilization rehabilitation.

Arthroscopic Shoulder Stabilization Rehabilitation