Anterior Stabilisation

ANTERIOR STABILISATION
No combined full abduction with external rotation for 12 weeks. Avoid sharp pain throughout.

Weeks 0 – 3

  • Keep sling on at all times except for washing and dressing.
  • Active wrist flexion/extension.
  • Active elbow flexion/extension – except in the case of SLAP/biceps repair, in which case passive elbow flexion/extension only until 6 weeks.
  • Forearm supination/pronation – except in the case of SLAP/biceps repair, in which case passive forearm supination/pronation only until 4 weeks.

Weeks 4 – 6

  • Scapulothoracic exercises to address any underlying scapula dyskinesis.
  • Pendulum exercises.
  • Active assisted flexion to 90 degrees.
  • Passive flexion as far as comfortable into range.
  • Active assisted abduction to 60 degrees.
  • External rotation to neutral only
  • Isometric rotator cuff with arm by side in neutral.
 
Weeks 6 – 12

  • Gradually wean off sling during the day, continue to wear at night.
  • Gradually increase to full active ROM except for external rotation which should be 80% of the range of the contralateral side. External rotation should be progressed gently and with care.
  • Strengthen rotator cuff through range.
  • Proprioceptive exercises in NWB.

Weeks 12+

  • Should aim to achieve FULL ROM, gaining last 20 degrees of external rotation.
  • Functional/sports specific training.

Functional Activities

  • Driving – 8 weeks.
  • Swimming – breaststroke – 8 weeks.
  • Golf – 3 months.
  • No contact sports for 6 months.