Shoulder Instability — Anterior Instability Repair

Saint Louis University (SLUCare)

Weight-Bearing

N/A

Key Restrictions

Sling at all times wks 1-4; passive FF limit 90 deg and ER/extension to neutral only wks 1-3; AAER limit 30 deg wks 3-6; go SLOW with ER wks 6-12; isokinetic IR 85% unaffected before Phase IV

Timeline & Phases

Wks 1-3: sling at all times, passive FF scapular plane to 90 deg, passive ER/extension to neutral, elbow/wrist AROM, scapular isometrics, pain-free deltoid isometrics; advancement criteria: ER neutral, FF 90 deg; Wks 3-6: DC sling after wk 4, AAFF to 120 deg, AAER to 30 deg, manual scapular exercises, IR/ER isometrics; advancement criteria: ER 45 deg, FF 120 deg, IR/ER 4/5; Wks 6-12: AAFF to tolerance, AAER to tolerance (slow), begin AROM IR, scapular strengthening + CKC, isotonic IR/ER modified neutral, latissimus strengthening, humeral head stabilization, UE flexibility, isokinetics; advancement criteria: normal scapulohumeral rhythm, full ROM, IR/ER 5/5, isokinetic IR 85%; Wks 12-18: full ROM, IR/ER to 90/90 if required, full UE strengthening, plyometrics, sport/activity program, throwing; discharge: pain-free sport program, isokinetic IR/ER equal to unaffected, independent HEP

Notes

SLU Sports Medicine and Shoulder Service; diagnosis: glenohumeral instability (anterior); 4-month protocol 2-3 visits/week