Superior Capsular Reconstruction Protocol

Weeks 0-1:

• Patient to do Home Exercises given post-op (pendulums, elbow ROM, wrist ROM, grip strengthening)
• Patient to remain in sling for 6 weeks

Weeks 1-6:

• True PROM only! The rotator cuff tendon needs to heal back into the bone
• ROM goals: 140° FF/40° ER at side; ABD max 60-80° without rotation
• No resisted motions of shoulder until 12 weeks post-op
• Grip strengthening
• No canes/pulleys until 6 weeks post-op, because these are active-assist exercises
• Heat before PT, ice after PT

Weeks 6-12:

• Begin AAROM - AROM as tolerated
• Goals: Same as above, but can increase as tolerated
• Light passive stretching at end ranges
• Begin scapular exercises, PRE's for large muscle groups (pees, lats,)
• At 8 weeks, can begin strengthening/resisted motions
• Isometrics with arm at side beginning at 8 weeks

Months 3-12:

• Advance to full ROM as tolerated with passive stretching at end ranges
• Advance strengthening as tolerated: isometrics > bands > light weights (1-5 lbs.); 8-12 reps/2-3 sets per rotator cuff, deltoid, and scapular stabilizers
• Only do strengthening 3x/week to avoid rotator cuff tendonitis
• Begin eccentrically resisted motions, plyometrics ( ex. Weighted ball toss), proprioception ( es. body blade)
• Begin sports related rehab at 4 ½ months, including advanced conditioning
• Return to throwing at 6 months
• Throw from pitcher's mound at 9 months
• Collision sports at 9 months
• MMI is usually at 12 months post-op