Posterior Shoulder Instability Repair — Posterior Shoulder Stabilization

SOMOS (Society of Military Orthopaedic Surgeons) · Tri-Service Orthopedics & Physical Therapy Consultants

Weight-Bearing

N/A (Upper Extremity)

Key Restrictions

Sling full-time 4 wks then wean by 6 wks; ER limited to 0° (not 30°) wks 1-4; Phase 1 staged ROM: FLEX <90°, ER 15-20°(wks 1-2)/30°@40°(wks 3-4)/45°@50°(wks 5-6), ABD 30°/0°/0°; no push-ups/bench press/pec flys/throwing/overhead Phase 2; Phase 3: P/A GH mobs only (not A/P); push-up progression starts 16 weeks; RTS 6-12 months

Timeline & Phases

Phase 1 (wks 0-6): same structure as anterior but with different ROM limits — ER 0° wks 1-4 (vs 15-30° anterior), PROM/AAROM hammer grip, scapular mobs, pendulums, hand squeezes, elbow/wrist AROM, shoulder isometrics, BFR uninvolved/LE; Phase 2 (wks 7-12): staged ROM (FLEX 135° wks 7-9 / 160° or symmetric by 12 wks, ER 45°/90° ABD wks 7-9 / 60°/90° ABD or symmetric by 12 wks, IR 30-45°/45° ABD wks 7-9 / symmetric by 12 wks), no push-ups/bench/pec flys/overhead — ROM, trunk NWB, scapular strengthening, shoulder PREs, bike then elliptical/treadmill; Phase 3 (wks 10-12 to 4-6 months): normalize ROM, trunk FWB, P/A GH mobs only (not A/P as in anterior), push-up progression starts 16 weeks; Phase 4 (4-6 months): same as anterior protocol; RTS 6-12 months

Notes

Posterior surgical procedures addendum within same PDF as anterior protocol; key differences: ER 0° early wks, P/A GH mobs only Phase 3, push-up progression at 16 wks (vs 12 wks anterior); Tri-Service May 2020; military population

Surgeon / Author

Tri-Service Orthopedics & Physical Therapy Consultants

Published

2020