Shoulder rehab protocols

Question 1

SLAP 0-6 weeks post op

Answer 1

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

Question 2

SLAP 7-12 weeks post op

Answer 2

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.

Question 3

SLAP 4-6 months post op

Answer 3

phase III goals: pushups at own pace w/o pain.

Precautions: no participation in contact/collision sports till 9 months post op.

ROM guidelines:

Question 4

AC joint reconstruct 0-8 weeks post op

Answer 4

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.

Question 5

AC joint reconstruct 9-16 weeks post op

Answer 5

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.

Question 6

AC joint reconstruct 5-6 months pot op

Answer 6

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

Question 7

Shoulder accelerated SAD/DCR/Scope 0-4 weeks post op

Answer 7

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.

Question 8

Shoulder accelerated SAD/DCR/Scope 5-8 weeks post op

Answer 8

phase II goals: full shoulder ROM. pain free ADLs.

Precautions: no reg pushups, heavy lifting, other sports participation.

Question 9

Shoulder accelerated SAD/DCR/Scope 2-3 months post op

Answer 9

phase III goals: pushups at own pace without pain. > 90% IR/ER strength return.

Precautions: progress as tolerated.

Question 10

Biceps Tenodesis 0-6 weeks post op

Answer 10

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

Question 11

Biceps Tenodesis 7-12 weeks post op

Answer 11

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

Question 12

Biceps Tenodesis 5-6 months post op

Answer 12

phase III goals: pushups at own pace without pain. > 90% IR/ER strength return.

Precautions: no participation in contact/collision sports until 9 months

Question 13

Pec major repair 0-6 weeks post op

Answer 13

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)

Question 14

Pec major repair 7-12 weeks post op

Answer 14

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

Question 15

Pec major repair 4-6 months post op

Answer 15

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.

Question 16

Posterior shoulder repair 0-6 weeks post op

Answer 16

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

Question 17

Posterior shoulder repair 7-12 weeks post op

Answer 17

phase II goals: full shoulder fx and ER, ~90% full IR. Pain free with ADLs.

precautions: no pushups, heavy lifting, or other sports participation.

Question 18

Posterior shoulder repair 4-6 moths post op

Answer 18

phase III goals: pushups at own pace without pain. > 90% IR/ ER strength return.

Precautions: no participation in contact/collision sports until 9 months

Question 19

RTC repair 0-6 weeks post op

Answer 19

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.

Question 20

RTC repair 7-12 weeks post op

Answer 20

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.

Question 21

RTC repair 4-6 months post op

Answer 21

phase III goals: pushups at own pace without pain. > 90 % IR/ER strength return.

precautions: no contact/collision participation until 9 months

Question 22

Clavicle ORIF 0-6 weeks post op

Answer 22

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.

Question 23

Clavicle ORIF 6-12 weeks post op

Answer 23

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