Posterior Capsular Shift

Phase I: Protect Repair (0 to 8 weeks)

• Patients may shower immediately over clear plastic, waterproof dressing
• Sutures are all underneath the skin and will dissolve on their own
• Ice or cold flow systems encouraged for the first week at a minimum: should be used 3-4 times per day.
• Brace should be in place when not performing exercises.
• Avoid ROM into flexion and IR.
• Initiate exercise program 3 times per day:
1. Immediate elbow, forearm and hand range of motion
2. Passive and ER to 30

Phase II:Progress ROM and protect repair (8 to 12 weeks)

• May discontinue brace.
• Lifting restriction of 5 pounds with the involved extremity.
• Initiate gentle rotator cuff strengthening.
• Avoid flexion > 130 and IR in abducted position > 30.
• Advance active and passive ROM:
1. ER at the side and scapular plane elevation to tolerance
2. Flexion to 130
3. Extension to tolerance
4. IR from abducted position to 30 degrees

Phase III: Full Function (>3 months)

• Begin combined full flexion and IR from abducted position.
• Discontinue lifting restrictions.
• Advance rotator cuff and scapular stabilizer strengthening.
• Initiate functional progression to sports specific activities at 4 months.

Posterior Capsulolabral Reconstruction (Arthroscopic)

Phase I: Protect Repair (0 to 6 weeks)

• May remove dressing and shower postop day # 3.
• Sutures are all underneath the skin and will dissolve on their own.
• Ice or cold flow systems encouraged for the first week at a minimum: should be used 3-4 times per day
• Brace should be in place when not performing exercises.
• May start active scapular mobility exercises at 3 to 4 weeks – Must keep the shoulder musculature relaxed.
• Initiate exercise program 3 times per day:
• Avoid IR ROM and flexion greater than 90.
• Initiate exercise program 3 times per day:
1. Immediate elbow, forearm and hand range of motion
2. Passive and active assistive ER at the side to 60, scapular plane abduction to 90, flexion to 90 only

Phase II:Progress ROM and protect repair (6 to 12 weeks)

• May discontinue brace.
• Lifting restriction of 5 pounds with the involved extremity.
• Initiate gentle rotator cuff strengthening.
• Continue scapular stabilizer strengthening.
• Avoid IR in abducted position > 30 and cross body shoulder motion
• Advance active and passive ROM:
1. ER at the side and scapular plane elevation to tolerance
2. Flexion to tolerance – shld should be in externally rotated position
3. Extension to tolerance
4. IR from abducted position to 30 degrees

Phase III: Full Function (>3 months)

• Begin combined full flexion and IR from abducted position.
• Discontinue lifting restrictions.
• Advance rotator cuff and scapular stabilizer strengthening.
• Initiate functional progression to sports specific activities at 4 months.

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