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 à bands à 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.
