Posterior Shoulder Stabilization

Phase I (Weeks 0-6)

1. Sling immobilization at all times (in flexion, abduction and 0° of rotation) except for showering and rehab under guidance of PT
2. Range of Motion – None for Weeks 0-3Weeks 3-6: Begin passive ROM – Restrict motion to 90° of Forward Flexion, 90° of Abduction, and 45° of Internal Rotation
3. Weeks 3-6: Begin passive ROM – Restrict motion to 90° of Forward Flexion, 90° of Abduction, and 45° of Internal Rotation
4. Therapeutic ExerciseElbow/Wrist/Hand Range of MotionGrip StrengtheningStarting Week 3: Begin passive ROM activities: Codman’s, Anterior Capsule Mobilization
5. Elbow/Wrist/Hand Range of Motion
6. Grip Strengthening
7. Starting Week 3: Begin passive ROM activities: Codman’s, Anterior Capsule Mobilization
8. Heat/Ice before and after PT sessions 

Phase II (Weeks 6-12)

1. Sling immobilization for comfort only
2. Range of Motion – Begin AAROM/AROMGoals: 135° of Forward Flexion, 120° of Abduction, Full External Rotation
3. Goals: 135° of Forward Flexion, 120° of Abduction, Full External Rotation
4. Therapeutic ExerciseContinue with Phase I exercisesBegin active-assisted exercises – Deltoid/Rotator Cuff IsometricsStarting Week 8:  Begin resistive exercises for Rotator Cuff/Scapular Stabilizers/Biceps and Triceps (keep all strengthening exercises below the horizontal plane during this phase – utilize exercise arcs that protect the posterior capsule from stress)
5. Continue with Phase I exercises
6. Begin active-assisted exercises – Deltoid/Rotator Cuff Isometrics
7. Starting Week 8:  Begin resistive exercises for Rotator Cuff/Scapular Stabilizers/Biceps and Triceps (keep all strengthening exercises below the horizontal plane during this phase – utilize exercise arcs that protect the posterior capsule from stress)
8. Modalities per PT discretion

 Phase III (Weeks 12-16)

1. Range of Motion – Progress to full AROM without discomfort
2. Therapeutic Exercise – Advance Phase II exercisesEmphasize Glenohumeral Stabilization, External Rotation and Latissimus eccentricsBegin UE ergometer/endurance activities
3. Emphasize Glenohumeral Stabilization, External Rotation and Latissimus eccentrics
4. Begin UE ergometer/endurance activities
5. Modalities per PT discretion

Phase IV (Months 4-6)

1. Range of Motion – Full without discomfort
2. Therapeutic Exercise – Continue with strengtheningSport/Work specific rehabilitation – Plyometric and Throwing/Racquet ProgramContinue with endurance activitiesReturn to sports at 6 months if approvedModalities per PT discretion
3. Sport/Work specific rehabilitation – Plyometric and Throwing/Racquet Program
4. Continue with endurance activities
5. Return to sports at 6 months if approved
6. Modalities per PT discretion