Download Shoulder Posterior Labrum Repair Rehab Protocol

Shoulder Posterior Labrum Repair Rehabilitation Protocol

0-2 Weeks Post Op

  • Arm in sling/immobilizer for 4 weeks
  • Modalities as needed
  • Pendulum exercises
  • PROM with ATC or PT no shoulder pulleys

Flexion to 90°, Abduction to 90°, Internal Rotation to 10° in scapular plane,

External Rotation to 30°, And Extension to neutral

  • Isometric strengthening and ROM of the hand, wrist, and elbow

2 Weeks Post Op 

  • Continue sling until 4 weeks post-op
  • Avoid all active ROM exercises
  • Advance PROM to: may use shoulder pulleys if tolerated, protect posterior capsule

Flexion to 110°, Abduction to 100°, Extension to neutral, Internal Rotation to 30° in plane of scapula, And External Rotation to 50°  in plane of scapula

  • Wall walks

3 Weeks Post-Op

  • Begin AAROM without restriction

4 Weeks Post Op

  • Discontinue sling/immobilizer
  • No IR or ER resistance exercises
  • Periscapular isometrics
  • Full PROM/AAROM
  • Progress from AAROM to AROM as tolerated:
    • Quality movement only, avoid forcing active motion with substitution patterns.
    • Remember the effects of gravity on the limb, do gravity eliminated motions first ie. Supine flexion.
  • Deltoid isometrics.
  • Lightly resisted elbow flexion

6 Weeks Post Op

  • Advance ROM to full as tolerated, do not crank on IR but progress it as tolerated,
  • Begin standing isotonic RC exercises with arm in neutral, below 90°
  • Continue periscapular isometrics
  • Joint mobilization

10 Weeks Post Op

  • Advance Rotator cuff strengthening to 8-10lbs on all motions
  • Advance proprioception ex’s as tolerated

 12 Weeks Post Op 

  • Add Eccentric ex’s to posterior cuff with T-band in standing simulating follow through in throwing or side-lying ER
  • Full ROM isokinetics
  • May begin conventional weight lifting using machines and progressing to free weights if desired as tolerated

14 Weeks Post Op 

  • Begin light tennis ball tossing at 20-30ft. max at 60% velocity, work on mechanics of wind up, early cocking phase, late cocking phase, acceleration, and follow through

 16-24 Weeks Post Op 

  • Throwers must pass strength test to begin throwing
  • Retest monthly till strength test passed
  • Continue with maintenance strengthening

Return to Sport/Activity

  • When cleared by physician
  • Pass strength test
  • Throwers complete throwing program
  • No pain with all desired level of activities