Post-Operative Therapy Shoulder Latarjet

Note: This pathway is designed to serve as a guide to rehabilitation. Indications for progression should be based on patient’s complete operative procedure, functional capacity and response to treatment.

Protective Phase | Phase I – Immediate Motion Phase | Weeks 0-7

Weeks 0-2

• Sleep in immobilizer for 4 weeks
• Immobilizer 24hours/day except for PT
• Elbow and Hand ROM
• Hand gripping exercises
• Gentle shoulder AAROM exercises with T-bar or cane
  • Flexion to tolerance (90 degrees max)
  • ER and 20 degrees Abduction – to tolerance (maximal motion 15-20 degrees)
  • IR at 20 degrees Abduction – to tolerance (maximal motion 45 degrees)
  • Rope and Pulley
• Isometrics for ER, IR, abduction, biceps with arm at side (0 degrees abduction)
• Cryotherapy and modalities as needed

Weeks 3-4

• Discontinue use of immobilizer except for sleep
• Continue gentle ROM exercises with T-bar (cane)
  • Flexion to tolerance (maximal 120-140 degrees)
  • ER (45 degrees abduction) – acceptable 20-30 degrees
  • IR in (45 degrees abduction) – acceptable 45-60 degrees
  • Initiate light isotonic for shoulder musculature – abduction, supraspinatus, ER, IR and biceps
  • Initiate scapular strengthening exercises with emphasis on trapezius and serrates anterior
  • Continue use of cryotherapy

Weeks 5-6

• Gradually improve Rom with T-bar (cane)
  • Flexion to maximum 160 degrees
  • ER at 90 degrees abduction: 45-60 degrees (maximum)
  • IR at 90 degrees abduction: 65-75-60 degrees (maximum)
• Diagonal patterns, manual resistance
• Rhythmic stabilization progression
• Progress all strengthening exercises in neutral position

Rehabilitation Phase | Phase II – Intermediate | Weeks 8-14

Weeks 8-10

• Progress to full Rom (weeks 8-10)
  • Flexion to 180 degrees
  • ER at 90 genres abduction: (90 degrees)
  • IR at 90 degrees abduction: (85 degrees)
• Continue to progress isotonic strengthening program
• Continue all scapular strengthening
• Initiate isokinetic exercise program in neutral if available

Weeks 10-14

• Continue all flexibility exercises, self-capsular stretches
• Throwers 10 program
• Diagonal pattern manual resisted exercise programs
• UBE 90 degrees abduction

Rehabilitation Phase | Phase III – Advanced Phase | Months 4-6

• Continue all stretching exercises (capsular stretches)
• Maintain throwers motion (especially ER)
• Continue throwers 10 program
• Isokinetic ER/IR (90-90 position)
• Plyometric exercises
  • May begin interval throwing program when approved by physician

Rehabilitation Phase | Phase IV – Return to Activity | Months 6-9

• Aggressive strengthening program for shoulder and scapular musculature
• Continue throwers 10 program
• Progress interval throwing
• Begin unrestricted throwing