Latarjet Coracoid Process Transfer
Phase I (Weeks 0-4)
- Sling to be worn at all times except for showering and rehab under guidance of PT
- Range of Motion – True Passive Range of Motion Only to Patient ToleranceGoals: 140° Forward Flexion, 25° External Rotation in the 30° abducted position, 60-80° Abduction in the plane of the scapula without rotation, Limit Internal Rotation to 45° with the shoulder in the 30° abducted positionMaintain elbow at or anterior to mid-axillary line when patient is supine
- Goals: 140° Forward Flexion, 25° External Rotation in the 30° abducted position, 60-80° Abduction in the plane of the scapula without rotation, Limit Internal Rotation to 45° with the shoulder in the 30° abducted position
- Maintain elbow at or anterior to mid-axillary line when patient is supine
- Therapeutic Exercise – No canes or pulleys during this phaseCodman Exercies/PendulumsElbow/Wrist/Hand Range of Motion and Grip StrengtheningIsometric Scapular Stabilization
- Codman Exercies/Pendulums
- Elbow/Wrist/Hand Range of Motion and Grip Strengthening
- Isometric Scapular Stabilization
- Heat/Ice before and after PT sessions
Phase II (Weeks 4-10)
- Discontinue sling immobilization at 6 weeks post-op
- Range of Motion4-6 weeks: PROM -> FF and Abduction to tolerance, 45° External Rotation in the 30° abducted position6-10 weeks: Begin AAROM -> AROM as tolerated: ER/IR to toleranceGoals: FF/Abduction > 155⁰, ER/IR >75⁰ at 90⁰ of shoulder abduction
- 4-6 weeks: PROM -> FF and Abduction to tolerance, 45° External Rotation in the 30° abducted position
- 6-10 weeks: Begin AAROM -> AROM as tolerated: ER/IR to toleranceGoals: FF/Abduction > 155⁰, ER/IR >75⁰ at 90⁰ of shoulder abduction
- Goals: FF/Abduction > 155⁰, ER/IR >75⁰ at 90⁰ of shoulder abduction
- Therapeutic Exercise4-6 weeks: Being gentle AAROM exercises (supine position), gentle joint mobilizations (grades I and II), continue with Phase I exercises6-10 weeks: Progress to active exercises with resistance, shoulder flexion with trunk flexed to 45° in upright position, begin deltoid and biceps strengthening,
- 4-6 weeks: Being gentle AAROM exercises (supine position), gentle joint mobilizations (grades I and II), continue with Phase I exercises
- 6-10 weeks: Progress to active exercises with resistance, shoulder flexion with trunk flexed to 45° in upright position, begin deltoid and biceps strengthening,
- Modalities per PT discretion
Phase III (Weeks 10-16)
- Range of Motion – Progress to full AROM without discomfort
- Therapeutic ExerciseContinue with scapular strengtheningContinue and progress with Phase II exercisesBegin Internal/External Rotation IsometricsPush up plus (wall, counter, knees on floor, floor)
- Continue with scapular strengthening
- Continue and progress with Phase II exercises
- Begin Internal/External Rotation Isometrics
- Push up plus (wall, counter, knees on floor, floor)
- Modalities per PT discretion
Phase IV (Months 4-6)
- Range of Motion – Full without discomfort
- Therapeutic Exercise – Advance strengthening as tolerated: isometrics -> therabands -> light weights8-12 repetitions/2-3 sets for Rotator Cuff, Deltoid and Scapular StabilizersReturn to sports at 6 months if approved
- 8-12 repetitions/2-3 sets for Rotator Cuff, Deltoid and Scapular Stabilizers
- Return to sports at 6 months if approved
- Modalities per PT discretion