Shoulder Instability — Arthroscopic / Open Capsular Shift

Saint Louis University (SLUCare)

Weight-Bearing

N/A

Key Restrictions

ER sling at all times including sleep wks 0-4; no active abduction/horizontal adduction/FF/IR wks 0-4; pendulum starts wk 2; passive FF to 90 deg + ER to 30 deg starts wk 2; ROM limits mo 1-2; avoid low rep/high weight indefinitely; full return pending Dr. Kaar or Dr. Cutuk approval

Timeline & Phases

Mo 0-1: ER sling at all times including sleep, AROM neck/elbow/wrist/hand 5x/day, no active abduction/horizontal adduction/FF/IR, pendulum at wk 2, passive FF to 90 deg and ER to 30 deg starting wk 2, icing 3-5x/day; Mo 1-2: DC sling after wk 4, passive and AAROM (15 deg horizontal abduction to full, no IR/adduction, full scapular plane, 45 deg IR/ER, extension to 20 deg), isometrics within limits, periscapular strengthening, shrugs, scapular retraction; Mo 2-4: slowly increase to full ROM, strong emphasis on periscapular strengthening (protraction, retraction, elevation), rotator cuff strengthening with bands/dumbbells when active ROM full, normalize scapulothoracic and glenohumeral rhythm; Mo 4-6: full ROM required, active shoulder and periscapular strengthening with high rep/low weight bands and dumbbells; Mo 6-8: advanced strengthening, no low rep/high weight indefinitely, functional training (swimming, tennis, interval throwing if thrower), gradual return to sport; return to sport: full ROM, no pain, satisfactory clinical exam, surgeon approval

Notes

SLU Sports Medicine and Shoulder Service; diagnosis: glenohumeral instability; covers arthroscopic and open capsular shift; Dr. Kaar and Dr. Cutuk; 8-month timeline; avoid low rep/high weight indefinitely; return to sport pending surgeon approval; 2-3 visits/week mo 1-4