ORIF Greater Tuberosity + Bony Bankart
Outpatient Physiotherapy Phase 1: (Weeks 2-5)
ROM
- Cervical, elbow and wrist ROM
- Supine Passive ROM forward elevation to: 130 external rotation to:20
- Instruct Home Exercise Program
Strengthening
- No cuff strengthening
- Begin and instruct in program of postural correction
- May begin scapular retraction and depression
- Grip strengthening
Sling
- Arm in sling at all times except for exercises and bathing; includes sling at night (sleeping in recliner chair optimal); Discontinue sling at 6 weeks
Outpatient Physiotherapy Phase 2: (Weeks 6-8)
ROM
- Begin self-assisted forward elevation to 90° and progress in 20° increments per week
- Use Pulleys
- Begin self-assisted ER with progressive return to full in 20° increments per week
- IR in scapular plane as tolerated (No IR behind back)
- No cross body adduction
- Grade I-II scapulothoracic and glenohumeral mobilizations
Strength
- No cuff strengthening
- Continue scapular retraction and depression
- Lower extremity aerobic conditioning
Other
- Modalities to decrease pain and inflammation
- Cryotherapy as necessary
Outpatient Physiotherapy Phase 3: (Weeks 9-12)
ROM
- Progressive return to full forward elevation and external rotation
- May begin posterior capsular stretching program
- May begin IR behind back
- Grade III-IV glenohumeral and scapulothoracic mobilizations
- Begin anterior chest wall stretches (pectoralis minor)
Strength
- Instruct in home program and begin submaximal isometrics in flexion, abduction, IR, ER and extension
- Add progressive isotonics with low resistance, high repetitions as tolerated
- Emphasize anterior deltoid strength and scapular stabilization
- Emphasize upper trapezius, serratus anterior force couple rehabilitation to create stable scapular base
- Assess for and correct compensatory movement patterns
- UBE with low resistance
- Continue aerobic conditioning
Outpatient Physiotherapy Phase 4: (> Week 12)
ROM
- Progressive return to full motion in all planes
- Emphasize posterior capsule stretching
- Maintenance home flexibility program
Strength
- Continue rotator cuff and scapular strengthening program
- Progressive increase in resistance as strength improves
- Continue UBE with progressive resistance as tolerated
- Recreation/vocation specific rehabilitation
- Maintenance aerobic conditioning home program
You will need the Adobe Reader to view and print these documents.
