Weeks 1-4:
- Sling for 2 weeks
- PROM, AAROM, AROM of elbow without resistance. This gives biceps tendon time to heal into new insertion site on humerus without being stressed
- Encourage pronation/supination without resistance
- Grip strengthening
- Maintain shoulder motion by progressing PROM > AROM without restrictions
- ROM goals: Full passive flexion and extension at elbow; full shoulder AROM
- No resisted motions until 4 weeks post-op
- Heat before PT sessions; other physical modalities per PT discretion
Weeks 4-12:
- Begin AROM for elbow in all directions with passive stretching at end ranges to maintain or increase
- biceps/elbow flexibility and ROM
- At 6 weeks, begin light isometrics with arm at side for rotator cuff and deltoid; can advance to bands as tolerated.
- At 6 weeks, begin scapular strengthening.
Weeks 8-12:
- Only do strengthening 3x/week to avoid rotator cuff tendonitis
- Begin UE ergometer
- Begin eccentrically resisted motions, plyometrics (ex-weighted ball toss), proprioception (ex-body blade), and closed chain exercises at 12 weeks.
- Return to throwing and begin swimming at 3 months
- Throw from pitcher's mound at 4 ½ months
- Collision sports at 6 months
- MMI is usually at 6 months
Other Shoulder PT Protocol
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