Orthopaedic Surgeon
Shoulder Labral Repair Surgical Rehabilitation
Phase I (2 – 6 weeks)
Appointments
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Home exercise program will begin after surgery
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1-3x/wk.
Rehabilitation Goals
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Reduce postoperative pain and inflammation
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Promote capsular healing
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Stop muscular atrophy
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Controlled motion to shoulder
Precautions
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Sling immobilization for 4 weeks, begin to wean when in a safe environment.
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Avoid ER and abduction
Range of Motion
Weeks 3-4
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AAROM and PROM
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Flexion 90-100 degrees
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ER at 45 degrees abduction scapular plane to 30 degrees
Weeks 5-6
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Flexion 145-160 degrees
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ER at 90 degrees abduction to 70 degrees
Suggested Therapeutic Exercise
Weeks 3-4
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Pendulum exercises and rope pulley
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Tubing ER/IR at 0 degrees abduction
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Isometrics- ER/IR at 0 degrees abduction, flexion, abduction,
scapular retraction, rhythmic stabilization, biceps
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Prone rowing
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Prone horizontal abduction (limited ROM)
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Lower trapezius table lifts
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Initiate proprioception drills
Weeks 5-6
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Initiate light isotonic exercises
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Full can
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Shoulder abduction
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Side lying ER
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Scapular strengthening
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Initiate light resistance CKC wall drills
Cardiovascular exercise
• Walking, stationary bike with sling on
• Avoid running/jumping (distractive forces)
Progression Criteria
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Full active ROM in all planes
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5/5 IR and ER strength at 0 degrees abduction
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Negative apprehension and impingement sign
Phase II (2-4 months post-operatively)
Appointments
• Rehabilitation appointments are 1-3 times per week
Rehabilitation Goals
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Gradually increase ROM and flexibility
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Enhance dynamic stabilization
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Improve muscular strength and endurance
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Gradually increase applied loads
Precautions
• Avoid passive and forceful movements into shoulder ER, extension and horizontal abduction.
Range of motion
Week 8-9
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Full flexion 180 degrees
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ER at 90 degrees abduction to 90 degrees
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IR at 90 degrees abduction to 65 degrees
Week 10-12
• ER at 90 degrees abduction to 110-115 degrees
Week 13-16
• Full range of motion
Suggested Therapeutic Exercise
Week 8-9
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Continue rhythmic stabilization
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Proprioceptive neuromuscular facilitation D2
flexion/extension with rhythmic stabilization
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Progress scapular strengthening program
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Push-ups on ball or table with rhythmic stabilization
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Wall stabilization onto ball into wall
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Tubing ER with manual resistance
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Closed kinetic chain drills
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Proprioceptive drills
Weeks 10-12
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Initiate self-capsular stretches
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Initiate 2 hand plyometric drills
Weeks 13-16
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Initiate progressive resistance exercises- bench press narrow grip, pull owns, pushups, seated rowing, pectoralis flies
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Plyometric one-hand drills/throws
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Wall dribble with 2 pound plyoball
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Initiate hitting program
Cardiovascular Exercise
• Walking, biking, Stairmaster and running (if cleared)
Progression criteria
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Full range of motion
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No apprehension or impingement signs
Phase III (4-6 months)
Appointments
• Rehabilitation appointments 1-3xwk
Rehabilitation Goals
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Patient to demonstrate stability with higher velocity movements and change of direction movements
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5/5 rotator cuff strength with multiple repetition testing
Precautions
• Progress gradually into proactive exercises by beginning with low velocity, known movement patterns
Suggested Therapeutic exercises
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Continue all flexibility and ROM exercises
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Continue self-capsular stretches
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Continue ER/IR stretches
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Plyometric two hand drills and one hand drills
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Endurance drills
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Core stabilization drills
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Initiate interval throwing program
Cardiovascular exercise
• Replicate sport or work specific energy demands
Progression Criteria
• Dynamic neuromuscular control with multi-plane activities without pain or swelling
Phase IV (6-8 months)
Appointments
• Rehabilitation appointments 1-3xwk
Rehabilitation Goals
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Patient to demonstrate stability with higher velocity movements and change of direction movements
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5/5 rotator cuff strength with multiple repetition testing
• Progress to unrestricted full activity
Precautions
• Progress gradually into sport specific demands
Suggested Therapeutic exercises
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Continue/progress strengthening exercises
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Initiate sport specific programs
Cardiovascular exercise
• Replicate sport or work specific energy demands
Progression Criteria
• Dynamic neuromuscular control with multi-plane activities without pain or swelling