Goal: Regain shoulder ROM
- Because the subscapularis tendon is taken down and then repaired, ER is limited early in the protocol to 20 degrees or as specified by orthopaedic surgeon.
- There is no limit to the flexion ROM.
- Full recovery takes 6 to 12 months
Phase I (0 to 6 Days)
- Active assisted ROM with pulleys for forward elevation (FE).
- Passive ROM FE, IR.
- Pendulum exercises.
- Elbow, wrist, and finger active ROM exercise.
- Educate patient on the above exercises for home.
- No ER past 20 degrees or as indicated by orthopaedic surgeon.
- Patients must remain in shoulder immobilizer at all times when not doing PT.
Phase II (7 to 20 Days)
- Add shoulder extension exercises.
- Begin assisted IR exercises behind back
- POD #14 – Add isometric exercises for ER, and ABD.
- Continue pulley FE exercises.
Phase III (3 to 6 Weeks)
- Add ER exercise. Limit ER to 30 degrees.
- Patients may use shoulder sling instead of shoulder immobilizer.
Phase IV (6 to 12 Weeks)
- Work to gain full ROM.
- ER with resistance. Full ER permitted.
- Rotator cuff, deltoid, and subscapularis strengthening.
- Discontinue sling.
Phase V (3 to 6 Months)
- Establish a home program so patient continues PT until at least 6 month post op.
- Work on an residual focal deficits.