Phase I (Weeks 0-6)
- Sling immobilization for first 4-6 weeks–out of sling to do home exercise program (pendulums) twice daily
- Range of Motion – PROM -> AAROM -> AROM as tolerated except No Active Internal Rotation/Backwards Extension For 6 Weeks (Protect Subscapularis Repair)
- Week 1 Goal: 90° Forward Flexion, 20° External Rotation at the Side, Maximum 75°Abduction
- Week 2 Goal: 120° Forward Flexion, 40° External Rotation at the Side, Maximum 75° Abduction
- Therapeutic Exercise
- Grip Strengthening
- Pulleys/Cane
- Elbow/Wrist/Hand Exercises
- Teach Home Exercises — Pendulums
- Heat/Ice before and after PT sessions
Phase II (Weeks 6-12)
- Discontinue sling if still being worn
- Range of Motion –AAROM/AROM – increase as tolerated with gentle passive stretching at end ranges
- Begin Active Internal Rotation and Backward Extension as tolerated
- Therapeutic Exercise
- Begin light resisted exercises for Forward Flexion, External Rotation and Abduction – isometrics and bands – Concentric Motions Only
- No Resisted Internal Rotation, Backward Extension or Scapular Retraction
- Modalities per PT discretion
Phase III (Months 3-12)
- Range of Motion – Progress to full AROM without discomfort
- Therapeutic Exercise
- Begin resisted Internal Rotation and Backward Extension exercises
- Advance strengthening as tolerated – Rotator Cuff, Deltoid and Scapular Stabilizers
- Begin eccentric motions, plyometrics and closed chain exercises
- Modalities per PT discretion