Labral Repair — Posterior Bankart Repair

Massachusetts General Hospital · MGH Sports Medicine

Weight-Bearing

Sling per surgeon, typically 4-6 wks; wean Phase II (wks 5-6); discharge sling Phase III (wks 7-12)

Key Restrictions

No IR Phase I; no horizontal adduction Phase I-III; no UE weight bearing Phase I-II; no overhead activities Phase I-II; no push-ups Phase III; IR behind back to beltline only Phase III; IR in scapular plane limited to 30 deg Phase II, 60 deg Phase III; IR at 90 deg ABD: 30-45 deg by wk 10, progress cautiously to 60-65 deg wk 12; ER to tolerance (unlike anterior where ER is restricted)

Timeline & Phases

5 phases: Phase I (0-4 wks, PROM: ER to tolerance, FF ≤120, pendulums; isometrics; grade 1-2 traction/inferior glides), Phase II (5-6 wks, AAROM/AROM: FF 140, IR ≤30 scapular plane, ER to tolerance; grade 1-3 mobs), Phase III (7-12 wks, D/C sling, progressive ROM/strength), Phase IV (13-20 wks, transitional, full ROM, 80% ER/IR strength), Phase V (21-28 wks, early return to sport, 90% strength and field testing, DASH/Penn Shoulder Score); revised 10/2021

Notes

Key differentiator from anterior: ER to tolerance (not restricted); IR is the restricted motion (opposite of anterior Bankart); no horizontal adduction x 12 wks; isokinetic testing (IR/ER 80-85%) for return to sport; KJOC for overhead athletes; criterion-based; references Dacey et al 2023 OJSM on lack of consensus in posterior stabilization rehab.

Surgeon / Author

MGH Sports Medicine