Anterior Shoulder Stabilization Rehabilitation Program
PHASE I: 1-3 WEEKS POST-OP
Range Of Motion
PROM
- Flexion: 90°
- Abduction: 90°
- ER: 30°
- IR: to belly
Sling
- Immobilized in sling with abduction pillow at all times, may be removed for exercises and showering. Wear sling at night.
Therapeutic Exercise
- Codman’s Pendulums
- Cervical ROM
- Begin scapula musculature isometrics / sets
- Elbow, wrist, hand ROM
- Ball squeezes
- General conditioning: bike, treadmill, etc.
- No AROM or AAROM
PHASE II: 3-6 WEEKS POST-OP
Range Of Motion
- Gradually increase Flexion / Extension to 80% of uninjured extremity
- Continue to limit ER and abduction – No ER past 90° in 90° of abduction
Sling
- Sling for comfort Week 3-4
- Transition out of sling Week 4
Therapeutic Exercise
- Begin AAROM exercises
- Pulley exercises
- Continue pool therapy if available
- Begin gentle rotator cuff isometric strengthening (ER at neutral)
- Periscapular strengthening
- Core strengthening
- Supine AAROM
PHASE III: 6 - 12 WEEKS POST-OP
Range Of Motion
- Progress to near full ROM (except abduction/external rotation)
- Continue to limit ER and abduction – No ER past 90° in 90° of abduction
Sling
- None
Therapeutic Exercise
- Begin AROM exercises
- Joint Mobilizations
- Rotator Cuff isometrics
- Elastic Resistance: ER/IR with elbow at the side of the body, forward punch, seated row, shoulder shrug, seated row, bicep curls, lat pulls, tricep extensions
- Gentle strengthening overhead: ER/IR in 90/90, D1/D2 flexion and extension diagonals
PHASE IV: 12-16 WEEKS POST-OP
Range Of Motion
- Progress to full ROM without discomfort
Sling
- None
Therapeutic Exercise
- Continue stretching and strengthening with resistance bands
- Can begin golf, tennis (no serves until 4 months)
- Progress free weight exercises (low weight, high reps)
- IR/ER: sidelying
- Supraspinatus: scapular plane
- Shoulder flexion: through pain free range of motion
- Arm ergometer/cycle for endurance exercise
PHASE V: 16+ WEEKS POST-OP
Range Of Motion
- Full ROM without discomfort
Sling
- None
Therapeutic Exercise
- Begin practicing skills at a low intensity level for specific sport
- For throwers, initiate a throwing program
- Tennis may begin serves
- Total body conditioning/ergometer cycle
