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Exercises should be performed 3 x daily, 5 days per week
Week 0-2
Range of Motion
Active assisted shoulder flexion in sling
Avoid shoulder external rotation past neutral
Strengthening
Scapular setting focusing on lower trapezius
Proprioception
Weightbearing through a theraball with arm by side and elbow bent
Week 2-6
Sling can be weaned at home, continue to wear in the community
Range of Motion
- Progress active assisted shoulder flexion to 100 degrees
- External rotation to 15 degrees
Strengthening
Scapular setting
Begin isometric shoulder internal and external rotation with arm by side
Proprioception
Progress weightbearing exercises through theraball to 70 degrees flexion
Week 6-12
Strengthening for scapular stability and rotator cuff
- Continue scapular setting exercises and grip strengthening
- Scapular setting can be done prone with horizontal extension, elbow bent with weight
- Abduction external rotation drills with arm in higher ranges of abduction ie 45, 60 then 90 degrees
- Internal rotation strengthening in differing ranges of shoulder abduction (in the plane of the scapula)
- Progress internal and external rotation strengthening with moderate theraband
- 15 repetitions with x 3 sets
- Internal rotation
- External rotation
- Shoulder flexion (bent elbow)
- Shoulder extension (bent elbow)
- Biceps and triceps strengthening
- Seated rows for mid and lower trapezius strengthening
- Bent over rows
Note: Avoid all over head strengthening push exercises
Proprioception
Semicircles with a theraball in 90 degrees abduction/flexion.
Week 12 to 6 months
Prior to progression you should see your surgeon to have either a CT scan or xray to confirm the bone block has united prior to progressing your rehabilitation.
Continue to progress range of motion and incorporating functional exercises and sport specific drills as indicated by your physiotherapist. This may include
- Plyometric training- supine with balls of differing weights throwing and catching supported by therapist (caution this exercise should be performed just prior to return to sport under the supervision of an experienced physiotherapist as re-dislocation is possible risk)
- Core stability training
- Proprioceptive retraining
-plyometric type theraball work against a wall
-body blade - Use of mirrors for motor recruitment retraining
- Theraband strengthening in the scapular plane at increasing ranges of motion
- Gym type scapular strengthening including seated rows, latissimus pull downs
- Gentle biceps strengthening from 4 months
Note: Avoid all overhead push exercises
Return to work/sport general guidelines
Please ask Dr McBride and your physiotherapist about your specific situation before progressing
Writing 2 weeks
Computer 2 weeks
Light duties 6 weeks
Moderate duties 3 months
Exercise bike 4 weeks
Running 6 weeks
Gym 8 weeks (light)
Golf 12 to 16 weeks
Swimming 6 months
Tennis 6 months
Contact sport, usually 4 months discuss with Dr McBride
Throwing sport, discuss with Dr McBride