Download Latarjet Open Anterior Shoulder Stabilization Rehab Protocol

Phase I MAXIMAL PROTECTION (0-4 Weeks Post-Op)

  • Immobilization for 4 weeks using sling
  • Elbow A/AAROM: flexion and extension
  • Protect anterior and posterior capsule from stretch, but begin passive ROM
  • Limit FE (supine forward elevation in the scapular plane) to 90 degrees
  • Limit ER (external rotation) to neutral 30 degrees
  • Do Not perform Pendulums
  • Modalities (i.e. CryoCuff) PRN(as needed)
  • Wrist and gripping excercises
  • Begin Deltoid/Cuff isometrics
  • Removal of sling for showering: maintain arm in sling position

Phase II MODERATE PROTECTION (4-6 Weeks Post-Op)

  • A/AAROM (Assisted Active Range Of Motion) Limit FE (forward elevation in the scapular plane) to 140 degrees
  • A/AAROM Limit ER (external rotation) to 45 degrees
  • Progress from AAROM to AROM:
    • 1) Quality movement only-avoid forcing active motion with substitution patterns.
    • 2) Remember the effects of gravity on the limb, do gravity eliminated motions first ie. Supine elevation in the scapular plane.
  • Deltoid isometrics
  • Elbow AROM
  • Continue with wrist exercises
  • Modalities PRN
  • Discontinue sling at 4-6 weeks


  • A/AAROM No Limit FE (forward elevation in the scapular plane)
  • A/AAROM No Limit ER (external rotation)
  • 10-12 weeks, AIAA/PROM to improve ER with arm in 45 degree abduction
  • AROM all directions below horizontal, light resisted motions in all planes
  • AROM activities to restore flexion, IR, horiz ADD as tolerated
  • Deltoid, Rotator Cuff isometrics progressing to isotonics
  • PRE’s for scapular muscles, latissimus, biceps, triceps
  • PRE’s work rotators in isolation (use modified neutral)
  • Emphasize posterior cuff, latissimus, and scapular muscle strengthening, stressing eccentrics
  • Utilize exercise arcs that protect anterior and posterior capsule from stress during PRE’s
  • Keep all strength exercises below the horizontal plane in this phase

Phase IV STRENGTHENING (12-16 Weeks Post-Op)

    • 1) Pain-free AROM
    • 2) Pain-free with manual muscle test
    • 3) Progress by response to treatment
  • AROM activities to restore full ROM
  • Restore scapulohumeral rhythm
  • Joint mobilization
  • Aggressive scapular stabilization and eccentric strengthening program
  • Initiate isotonic shoulder strengthening excercises including: side lying ER, prone arm raises at 0, 90, 120 degrees, elevation in the plane of the scapula with IR and ER, lat pulldown close grip, and prone ER
  • Dynamic stabilization WB and NWB
  • PRE’s for all upper quarter musculature (begin to integrate upper extremity patterns). Continue to emphasize eccentrics and glenohumeral stabilization.
  • All PRE’s are below the horizontal plane for non-throwers
    • 1) Begin isokinetics
    • 2) Begin muscle endurance activities (UBE)
      • High seat and low resistance
      • Must be able to do active shoulder flexion to 90 degrees without substitution
    • 3) Continue with agility exercises
    • 4) Advanced functional exercises
    • 5) Isokinetic test
    • 6) Functional test assessment
    • 7) Full return to sporting activities.

Please note that these instructions are general guidelines to be followed; however, any written or verbal instructions provided by Dr. Nwachukwu supersede the instructions below and should be followed.