Non-Operative — Anterior Shoulder Instability / Acute Anterior Dislocation (Non-Operative)

UCLA Department of Orthopaedic Surgery - Sports Medicine · Thomas Kremen MD

Weight-Bearing

N/A (upper extremity)

Key Restrictions

Immobilization 3-6 wks for initial episode; avoid anterior capsule stress throughout early phases; IR and limited arc ER below horizontal Phase III; full ROM all planes Phase IV; isokinetics in modified neutral Phase V

Timeline & Phases

Phase I: immobilization 3-6 wks (initial episode), elbow AROM/AAROM, hand/wrist/gripping exercises, modalities/cryotherapy | Phase II: AAROM/PROM for FF (pulley/wand/pool), pendulums, RC isometrics in scapular plane, PREs for scapular muscles/lat/biceps/triceps, posterior glide joint mobilization | Phase III: AROM below horizontal, restore scapulohumeral rhythm, joint mobilization, scapular stabilization avoiding anterior capsule stress, limited arc ER/IR below horizontal, limited arc isotonic deltoid in scapular plane | Phase IV: full ROM all planes, progress PREs cuff/scapular protecting capsule, eccentric strengthening, UBE endurance | Phase V: isokinetics in modified neutral/scapular plane, plyometric training for throwers, advanced proprioception, UBE | Phase VI: isokinetic test, throwing/racquet program, return to full activity

Notes

Non-operative PT prescription framework (not a post-surgical protocol); 6-phase rehabilitation for acute anterior shoulder dislocation/anterior instability; immobilization 3-6 wks for initial episode; emphasizes protecting anterior capsule throughout early phases; isokinetics and plyometric throwing training in Phase V; RTS via isokinetic test and throwing/racquet interval program Phase VI; Kremen MD UCLA PatientPop practice site

Surgeon / Author

Thomas Kremen MD