Phase I: (0-6 weeks)
Goals:
- Protect surgery
- Decrease pain and inflammation
- Gentle passive ROM
- Patient education
Plan:
- Ultra sling (0-6 weeks depending on repair)
- Hand, elbow, wrist exercises immediately post-op in sling
- Cervical spine stretches
- Modalities PRN
- Scapular mobilization and muscle tone
- Thoracic mobilization
- At 4-6 weeks post-op: Aquatic Therapy
- Pendulums – may begin at 2-3 weeks
- PROM (flexion to 90°, abduction to tolerance – being cautious with this movement, IR/ER as tolerated at 30° shoulder
- abduction)
Phase II (6-12 weeks)
Goals:
- Control pain and inflammation
- Continue to work on ROM throughout phase; use caution through-out.
- Begin gentle strengthening
Plan:
- Modalities PRN
- Aquatic therapy combined with gentle resistive activity
- Scapular and glenohumeral mobilization
- PROM (caution with flexion)
- Begin scapular strengthening
- Isometric IR/ER
- Bicep/triceps strengthening, UBE
Phase III (12-24 weeks)
Goals:
- Functional ROM
- Improve strength/neuromuscular – control
- End phase begin sport/activity training
Plan:
- Stretching PRN
- Instruct in self-stretching
- Increase strength and endurance of upper quadrant
- Begin machine weighted exercises
- Begin coordination exercises
- Biodex training/testing if requested by M D
Phase IV (24 weeks)
Goals:
- Maximum ROM
- Increase strength
- Return patient to sport/activity
Plan:
- Self-stretching
- Strengthening RTC at 0°, 45°, 90°
- Advanced machine weighted exercises
- Specific sports related activities