Weeks 0-4:
- Sling in neutral rotation for 3 weeks (padded abduction sling)
- Codman exercises, elbow and wrist ROM
- Wrist and grip strengthening
Weeks 4-6:
- Restrict to FF 90° /lR to stomach PROM > AAROM > AROM
- ER with arm at side as tolerated
- Begin isometrics with arm at side - FF/ER/lR /ABDI/ADD
- Start scapular motion exercises (traps/rhomboids/lev. scap/etc.)
- No cross-arm adduction, follow ROM restrictions No cross-arm adduction, follow ROM restrictions
Weeks 6-12:
- Increase ROM to within 20° of opposite side; no manipulations per therapist; encourage patients to work on ROM on a daily basis
- Once 140° active FF, advance strengthening as tolerated: isometrics > bands >
light weights
- (1-5 lbs.); 8-12 reps/2-3 sets per rotator cuff, deltoid, and scapular stabilizers with low abduction angles
- Only do strengthening 3x/week to avoid rotator cuff tendonitis
- Closed chain exercises
Months 3-12:
- Advance to full ROM as tolerated
- Begin eccentrically resisted motions, plyometrics ( ex. Weighted ball toss), proprioception ( ex. body blade)
- Begin sports related rehab at 3 months, including advanced conditioning
- Return to throwing at 4 ½ months
- Push-ups at 4 ½ - 6 months
- Throw from pitcher's mound at 6 months
- MMI is usually at 12 months post-op
Other Shoulder PT Protocol
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