Posterior Shoulder Instability Repair — Posterior Capsular Stabilization

University of Delaware Physical Therapy · UDPT Clinical Team

Weight-Bearing

Abduction sling 24 hrs/day weeks 1-4; abduction sling in crowds weeks 5-8; D/C sling after 6 weeks

Key Restrictions

Avoid High 5 / Low 5 positions; avoid IR behind the back for first 12 weeks; no formal PT weeks 1-4; AROM limits: ER 20° at 45° elevation (weeks 5-8), 45° at 90° elevation (weeks 9-12); IR to stomach at 0° elevation by weeks 9-12; full flex/ABD by weeks 12-15; no driving week 1

Timeline & Phases

Weeks 1-4 (no formal PT: sling, Codman exercises, isometrics in sling); Weeks 5-8 (1-3x/week, 3-9 visits: AROM/AAROM, isometrics, scapular control); Weeks 9-12 (1-3x/week, 6-18 visits: GHJ mobs, isotonics, rhythmic stabilization); Weeks 12-15 (1-2x/week, 9-24 visits: PROM, isokinetics, dynamic stabilization); Weeks 16-24 (bilateral plyometrics); Weeks 21-24 (unilateral plyometrics, interval throwing, return to sport drills); 9-32 total visits

Notes

University of Delaware PT Clinic; repair of posterior labrum and posterior band of IGH ligament; secondary: anterior repair; return to play: contact/power athlete 9-12 months, non-contact 8-12 months, recreational 6-9 months; return to sport criteria: pain free, full ROM, bilaterally equal strength; GHJ grade III/IV mobs for posterior only (no anterior/posterior glide mobs); isokinetics for RC in neutral initiated weeks 12-15; interval throwing program weeks 21-24

Surgeon / Author

UDPT Clinical Team