0-4 Weeks:
- Abduction or External Brace x4 weeks
- Grip Strength, Elbow/Wrist/Hand ROM
- Codmans Exercises
4-6 Weeks:
- Discontinue brace at 4 weeks unless otherwise indicated
- Begin Passive→AAROM → AROM
- Restrict FF to 90º, ER at side to tolerance
- IR to stomach., No cross body adduction
- No Manipulations per therapist
- Begin Isometric exercises with arm at side
- Deltoid/Scapular
- ER/IR (submaximal) with arm at side
- Begin strengthening scapular stabilizers
6-12 Weeks:
- Increase ROM to within 20º of opposite side. No manipulations per therapist. Encourage patient to work on ROM daily.
- Cont. Isometrics
- Once FF to 140º, Advance strengthening as tolerated: isometrics → bands → light weights (1-5 lbs); 8-12 reps/2-3 set per rotator cuff, deltoid, and scapular stabilizers.
- Only do strengthening 3times/wk to avoid rotator cuff tendonitis Closed chain exercises.
3-12 Months:
- Advance to full painless ROM
- Begin eccentrically resisted motions, plyometrics (ex weighted ball toss), proprioception (ex body blade), and closed chain exercises at 12 weeks.
- Begin sports related rehab at 3 months, including advanced conditioning
- Return to throwing at 4 ½ months
- Throw from pitcher’s mound at 6 months
- MMI is usually at 12 months
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.
