REHABILITATION PROTOCOL

Pre-Operative Evaluation

  • Document ROM

  • Discuss Post-op Protocol

  • Set up appointment to be seen on POD#4

  • Daily physical therapist first 2 weeks post-op, then 2-3 times/week for 4 weeks

  • Go over home exercises to be done by patient

 Post-Operative

Cryotherm unit and sling to shoulder, change ice every 2 hours. Encourage wrist, elbow & finger ROM.  Passive range of motion started almost immediately.

  • Elevation to 60°

  • Internal Rotation

  • External Rotator Isometrics

  • Anterior, Middle, and Posterior Deltoid Isometrics

  • External Rotation Limited to 25°

  • Cross Body Adduction

  • Grip Strengthening

EXPECT 5 EXERCISE SESSION FOR 10 MINUTES THROUGHOUT DAY DONE BY PATIENT.

WEEK 1-2
PROM-AAROM PHASE

Physical Therapist:

  • Supine Elevation to 140°

  • Forward lean

  • Supine External Rotation to 40°

  • Functional Internal Rotation & Adduction.

  • Swelling control

WEEK 3-4
STRENGTHENING PHASE

Physical Therapist

  • Isometric-isotonics to deltoid & external rotators

  • Strain-counterstrain

  • Scapular stabilization

WEEK 5-6
ADL PHASE

Physical Therpist

  • Functional adduction to wash & comb hair

  • External Rotation - door opening

  • Large ball & net, chest pass, underarm pass

  • Swinging golf club