Posterior Shoulder Instability Repair — Posterior Shoulder Stabilization

Sutter Health / Palo Alto Medical Foundation · Kevin Roth MD

Weight-Bearing

N/A (upper extremity)

Key Restrictions

Sling with abduction pillow; neutral rotation to a few degrees ER only (limits IR); NO pendulum exercises Phase I; sling worn with abduction pillow through wk 6; wean sling wk 5 for comfort; out of sling by wk 6; no IR isometrics until Phase III (performed in slight ER, not past neutral); no posterior glides in joint mobilization Phase III

Timeline & Phases

Phase I (wks 1-3): sling with abduction pillow (neutral rotation to a few degrees ER), NO pendulums, cervical ROM, scapular isometrics/sets, elbow/wrist/hand ROM, ball squeezes, general conditioning (bike/treadmill) | Phase II (wks 3-6): sling with abduction pillow continuing (wean for comfort at wk 5, out by wk 6), gradually increase PROM (FE 90°, abduction 90°, IR 45°, ER 90°), Codman's pendulums begin, anterior capsule mobilization, submaximal pain-free isometrics in scapular plane (flexion/abduction/extension/ER — no IR yet) | Phase III (wks 6-12): transition out of sling, near full ROM, AAROM/pulleys, joint mobilizations (no posterior glides), RC/deltoid isometrics, IR isometrics in slight ER (do not perform past neutral), periscapular strengthening, AROM by wk 8 | Phase IV (wks 12-16): full ROM, resistance bands, push-ups, free weights low weight/high reps, IR/ER sidelying, supraspinatus in scapular plane, shoulder flexion, arm ergometer | Phase V (wks 16+): sport-specific skills at low intensity, throwing program for throwers, tennis serves, total body conditioning

Notes

No publication date on document; NO pendulum exercises Phase I (compare to anterior stabilization which includes pendulums Phase I); sling in neutral rotation to a few degrees ER to avoid IR stress on posterior repair; Codman's pendulums begin Phase II (wks 3-6); no posterior joint glides in Phase III mobilization; IR isometrics in Phase III must be performed in slight ER (not past neutral); otherwise similar 5-phase structure and RTS timeline to anterior stabilization protocol; Kevin Roth MD Orthopedic Sports Medicine, Palo Alto CA (650-853-2943)

Surgeon / Author

Kevin Roth MD