Goals

• Use of a sling for 1-2 weeks post-op unless otherwise indicated.
• Maintenance of good postural positioning when performing all exercises.
• Aerobic conditioning throughout the rehabilitation process.
• M.D. follow-ups Day 1, 4 weeks, 3 months, 6 months and 1 year.
• All active exercises should be carefully monitored to minimize substitution or compensatioN.

Week 1

•  Change dressings and review home exercise program.

Manual

• Soft tissue mobilization to surrounding tissues, effleurage for edema.  
• Passive range of motion in all planes as tolerated.

Exercises

• Elbow flexion and extension, wrist and forearm strengthening.
• Cervical stretches, scapular squeezes, lower trap squeezes.
• It is important to come out of the sling frequently to bend and straighten elbow for 10-15 repetitions each time to minimize arm and hand swelling
• Well-body cardiovascular exercise (stationary bike, elliptical without arms, stairmaster).

Goals

• Decrease pain and edema.

• Passive range of motion flexion, scaption to 90 degrees, external rotation to 30 degrees.

Weeks 2 – 4

• Nurse visit for stitch removal at Day 14.

Manual

• Continue soft tissue treatments, passive range of motion, scapula glides, light joint mobilizations as tolerated
• Pain control (i.e. cryotherapy, massage, electric stimulation).

Exercises

• Begin isometrics in all planes
• Initiate active range of motion in all directions as tolerated.
• Scapular strength training exercises with theraband.
• General conditioning as tolerated (include trunk flexion & extension exercises).

Goals

• Decrease pain and edema.
• Passive range of motion flexion, scaption to 120 degrees, external rotation to 60 degrees.
• Active range of motion flexion, scaption, abduction to 90 degrees with good mechanics.

Weeks 4 – 6

Manual

• Continue as needed for soft tissue, fascial, and joint mobility.

Exercise

• Progress strength training exercises including weight bearing exercises, theraband exercises, and gym exercises.

Goals

• Full passive/active range of motion

Weeks 6 – 8

Manual

• Continue as needed for soft tissue, fascial, and joint mobility.

Exercise

• Continue to advance rotator cuff strengthening in multiple planes of movement (wall ball dribbling, step ups/downs in plank, prone scapular strengthening with weights).

• Initate light throwing type activities.

Weeks 8+

• Initiate sport specific training as tolerated with no pain.
• Continue strengthening, endurance training, and overall fitness.

All progressions are approximations and should be used as a guideline only. Progression will be based on individual patient presentation, which is assessed throughout the treatment process.