Shoulder Instabilty
Procedures:
- Arthroscopic Bankart / anterior Stabilisation
- Latarjet-Bristow Stabilisation Procedure
Post operative Protocol:
Pre-operative rehabilitation is advisable (Pre-hab)
| Post op |
Day 1 - 3 weeks Level 1 Exercises | - Sling for 3 weeks (athletes can wean off sooner under guidance of club therapist)
- Teach axillary hygiene
- Teach postural awareness and scapular setting
- Core stability exercises as appropriate)
- proprioceptive exercises (minimal weightbearing below 90 degrees)
- Active assisted flexion as comfortable (in 'safe zone' )
- Active assisted external rotation as comfortable (in 'safe zone' )
- Do not force or stretch
- No combined abduction & external rotation
|
3 - 6 weeks Level 2-3 exercises | - Wean off sling
- Progress active assisted to active ROM as comfortable
- Do not force or stretch
- No combined abduction & external rotation
|
6 - 12 Weeks Strengthening Proprioception Scapular control | - Regain scapula & glenohumeral stability working for shoulder joint control rather than range
- Gradually increase ROM
- Strengthen
- Increase proprioception through open & closed chain exercise
- Progress core stability exercises
- Ensure and treat posterior tightness, if required
- Incorporate sports-specific rehabilitation
- Plyometrics and pertubation training
|
| Milestones |
| Week 6 | Active elevation to pre op level |
| Week 12 | Minimum 80% range of external rotation compared to asymptomatic side
Normal movement patterns throughout range |
| Failure to achieve milestones | Referral to shoulder clinic |
Return to functional activities
|
| Return to work | Sedentary job: as tolerated
Manual job: 3 months |
| Driving | 6-8 weeks |
| Swimming | Breaststroke: 6 weeks
Freestyle: 12 weeks |
| Golf | 3 Months |
| Lifting | Light lifting can begin at 3 weeks. Avoid lifting heavy items for 3 months. |
| Contact Sport | E.g. Horse riding, football, martial arts, racket sports and rock climbing: 3 months |
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