• Sling allowed as needed for comfort only, first 5 - 7 days, taking arm out often 5 - 7 times a day for elbow ROM
• Posture education and postural exercises
• Ball or putty squeezing throughout the day
• Icing every two hours for 15 - 20 minutes first 5 - 7 days, 3 times a day thereafter
• CPM (continuous passive motion) machine 4 - 6 hours per day for 1 - 4 weeks
• Soft tissue mobilization focused on periscapular musculature, cervical spine, and rotator cuff
• Scapular mobilization
• Passive and active assisted ROM manually and using pulley at home going for full motion as soon as able without increased irritability
• Cardiovascular training program can include bike, treadmill, versa climber, UBE
• Core stabilization program

 2 - 4 Weeks:

• Full passive range of motion should be achieved by 2 - 4 weeks
• Scapular and glenohumeral joint mobilization as indicated
• Begin rotator cuff retraining and strengthening, focus on restoring proper biomechanics
• Integration of involved shoulder through bilateral UE activity and total motion training (full body movements using both upper and lower extremities)
• Continued cardiovascular and core strength training
• Continued icing 3 times per day

4 - 8 Weeks:

• Progressive strength training contingent upon perfect biomechanics
• Development of independent home and gym program
• Okay to return to swimming with good mechanics after 6 weeks

8 - 10 Weeks:

• Progression into normal activity and exercise program
• Patient discharged with life-long home maintenance program to include daily ROM exercises, rotator cuff program, and cardiovascular program

 

NOTE: All progressions are approximations and should be used as a guideline only. Progression will be based on individual patient presentation, which is assessed throughout the treatment process.