top of page

 Shoulder Labral Repair Surgical Rehabilitation

Phase I (2 – 6 weeks)

Appointments

  • Home exercise program will begin after surgery

  • 1-3x/wk.

Rehabilitation Goals

  • Reduce postoperative pain and inflammation

  • Promote capsular healing

  • Stop muscular atrophy

  • Controlled motion to shoulder

Precautions

  • Sling immobilization for 4 weeks, begin to wean when in a safe environment.

  • Avoid ER and abduction

Range of Motion

Weeks 3-4

  • AAROM and PROM

  • Flexion 90-100 degrees

  • ER at 45 degrees abduction scapular plane to 30 degrees

    Weeks 5-6

  • Flexion 145-160 degrees

  • ER at 90 degrees abduction to 70 degrees

Suggested Therapeutic Exercise

Weeks 3-4

  • Pendulum exercises and rope pulley

  • Tubing ER/IR at 0 degrees abduction

  • Isometrics- ER/IR at 0 degrees abduction, flexion, abduction,

    scapular retraction, rhythmic stabilization, biceps

  • Prone rowing

  • Prone horizontal abduction (limited ROM)

  • Lower trapezius table lifts

  • Initiate proprioception drills

    Weeks 5-6

  • Initiate light isotonic exercises

  • Full can

  • Shoulder abduction

  • Side lying ER

  • Scapular strengthening

  • Initiate light resistance CKC wall drills

Cardiovascular exercise

• Walking, stationary bike with sling on

• Avoid running/jumping (distractive forces)

Progression Criteria

  • Full active ROM in all planes

  • 5/5 IR and ER strength at 0 degrees abduction

  • Negative apprehension and impingement sign

 

Phase II (2-4 months post-operatively)

Appointments

• Rehabilitation appointments are 1-3 times per week

Rehabilitation Goals

  • Gradually increase ROM and flexibility

  • Enhance dynamic stabilization

  • Improve muscular strength and endurance

  • Gradually increase applied loads

Precautions

• Avoid passive and forceful movements into shoulder ER, extension and horizontal abduction.

Range of motion

Week 8-9

  • Full flexion 180 degrees

  • ER at 90 degrees abduction to 90 degrees

  • 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

  • Continue rhythmic stabilization

  • Proprioceptive neuromuscular facilitation D2

    flexion/extension with rhythmic stabilization

  • Progress scapular strengthening program

  • Push-ups on ball or table with rhythmic stabilization

  • Wall stabilization onto ball into wall

  • Tubing ER with manual resistance

  • Closed kinetic chain drills

  • Proprioceptive drills

    Weeks 10-12

  • Initiate self-capsular stretches

  • Initiate 2 hand plyometric drills

Weeks 13-16

  • Initiate progressive resistance exercises- bench press narrow grip, pull owns, pushups, seated rowing, pectoralis flies

  • Plyometric one-hand drills/throws

  • Wall dribble with 2 pound plyoball

  • Initiate hitting program

Cardiovascular Exercise

• Walking, biking, Stairmaster and running (if cleared)

Progression criteria

  • Full range of motion

  • No apprehension or impingement signs

 

Phase III (4-6 months)

Appointments

• Rehabilitation appointments 1-3xwk

Rehabilitation Goals

  • Patient to demonstrate stability with higher velocity movements and change of direction movements

  • 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

  • Continue all flexibility and ROM exercises

  • Continue self-capsular stretches

  • Continue ER/IR stretches

  • Plyometric two hand drills and one hand drills

  • Endurance drills

  • Core stabilization drills

  • 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

  • Patient to demonstrate stability with higher velocity movements and change of direction movements

  • 5/5 rotator cuff strength with multiple repetition testing

• Progress to unrestricted full activity

Precautions

• Progress gradually into sport specific demands

Suggested Therapeutic exercises

  • Continue/progress strengthening exercises

  • 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

bottom of page