Shoulder rehab protocols Flashcards
SLAP 0-6 weeks post op
phase I goals: protect an avoid stiff shoulder
Precautions: no active use of arm. Always wear sling, even while sleeping.
ROM guidelines: progress as tolerated
SLAP 7-12 weeks post op
phase II goals: full shoulder flx and IR. ~90% full ER. Pain free ADLs.
Precautions: no pushups, heavy lifting, other sports participation. No repetitive overhead use of shoulder.
Wean from sling.
SLAP 4-6 months post op
phase III goals: pushups at own pace w/o pain.
Precautions: no participation in contact/collision sports till 9 months post op.
ROM guidelines:
AC joint reconstruct 0-8 weeks post op
phase I goals: protect surgical repair. Avoid stuff shoulder.
Precautions: no elevation of shoulder past 90 deg. Must aways wear sling for 8 weeks, even while sleeping. No jogging/running.
AC joint reconstruct 9-16 weeks post op
phase II goals: full shoulder flx and IR, ~90% full ER. Pain free ADLs.
Precautions: Must wear sling until 12 weeks post op except during rehab. No repetitive overhead use of shoulder. No reg pushups, heavy lifting, or sports participation.
AC joint reconstruct 5-6 months pot op
phase III goals: pushup at own pace without pain. > 90% IR/ER strength return
Precautions: no participation in contact/collision sports until 9-12 months post op
Shoulder accelerated SAD/DCR/Scope 0-4 weeks post op
phase I goals: normal shoulder ROM. Pain free ADLs.
Precautions: no pushups, heavy lifting, other sports participation. No repetitive overhead shoulder use.
Sing use for comfort. Gradually wean off. Discharge use after 8-10 days.
Shoulder accelerated SAD/DCR/Scope 5-8 weeks post op
phase II goals: full shoulder ROM. pain free ADLs.
Precautions: no reg pushups, heavy lifting, other sports participation.
Shoulder accelerated SAD/DCR/Scope 2-3 months post op
phase III goals: pushups at own pace without pain. > 90% IR/ER strength return.
Precautions: progress as tolerated.
Biceps Tenodesis 0-6 weeks post op
phase I goals: protect surgical repair and avoid stuff shoulder
Precautions: no resistance exercises for elbow flx, shoulder abd, or flexion. No biceps > 1 lb for 6 weeks after surgery. Must always wear sling/immobilizer, even sleeping.
Abduction pillow worn with sling 3-4 weeks
Biceps Tenodesis 7-12 weeks post op
phase II goals: full shoulder and elbow ROM, pain free ADLs.
Precautions: no pushups, heavy lifting, or other sports participation. No repetitive overhead use of shoulder.
Wear sling
Biceps Tenodesis 5-6 months post op
phase III goals: pushups at own pace without pain. > 90% IR/ER strength return.
Precautions: no participation in contact/collision sports until 9 months
Pec major repair 0-6 weeks post op
phase I goals: protect surgical repair and avoid stiff shoulder
Precautions: no active use or arm x 2 weeks post op. Always wear sling, even sleeping.
After 2 weeks post op d/c sling in safe environment, no lifting more than 1 lb (ADLs)
Pec major repair 7-12 weeks post op
phase II goals: full shoulder ROM. Pain free ADLs.
precautions: no pushups, heavy lifting, or other sports participation. No repetitive use of overhead shoulder activity.
Wear sling
Pec major repair 4-6 months post op
phase III goals: pushups at own pace without pain.
Precautions: no participation on contact/collision sports until 9 months post op. High weight/low rep barbell pressing discouraged indef.
Posterior shoulder repair 0-6 weeks post op
phase I goals: protect surgical repair and avoid a stiff shoulder.
precautions: no active use of arm-must always wear sling while sleeping.
ROM guidelines: week 1-2 limit fx to 90 and IR to 0 (neutral), week 3-4 limit flx to 110 and IR to 0, weeks 5-6 limit fx to 130 and IR to 0.
Sling with ER brace x6 weeks
Posterior shoulder repair 7-12 weeks post op
phase II goals: full shoulder fx and ER, ~90% full IR. Pain free with ADLs.
precautions: no pushups, heavy lifting, or other sports participation.
Posterior shoulder repair 4-6 moths post op
phase III goals: pushups at own pace without pain. > 90% IR/ ER strength return.
Precautions: no participation in contact/collision sports until 9 months
RTC repair 0-6 weeks post op
phase I goals: protect surgical repair & avoid a stiff shoulder
precautions: np active use of arm- always wear sling, even while sleeping.
Sling with abduction x 6 weeks
ROM guidelines: weeks 102 allow slx 90 deg and ER O (neutral), weeks 3-4 allow fx 120 and ER 20, weeks 5-6 allow flx 150 and ER 40.
RTC repair 7-12 weeks post op
phase II goals: full shoulder ROM and pain free ADLs.
precautions: no pushups, heavy lifting, other sports participation. No repetitive overhead use of shoulder.
Wean from sling.
RTC repair 4-6 months post op
phase III goals: pushups at own pace without pain. > 90 % IR/ER strength return.
precautions: no contact/collision participation until 9 months
Clavicle ORIF 0-6 weeks post op
phase I goals: protect surgical reconstruction, retard muscle atroph, and dec pain/inflamm.
precautions: no pushups, heavy lifting, other sports participation. No active motion about 90 deg.
Sling: use for comfort. Wean off after 28-42 days.
Clavicle ORIF 6-12 weeks post op
phase II goals: reestablish full nonpainful ROM, minimize muscle atrophy, regain and improve muscle strength, and improve neuromuscular control of shoulder complex,
precautions: no reg pushups, heavy lifting, other sports
