Michael Metcalf, M.D. / M. Daniel Hatch, M.D.

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Phase 1

Sling

1. Full time use for first 6 weeks
2. Discontinue after week 6

Weeks 0-6

1. Hand, wrist and elbow active motion
2. Active scapular motion (shrugs, retraction)

Phase 2

Weeks 7-9

1. Begin active shoulder motion in all planes – (no restrictions unless otherwise specified)
   • Forward elevation
   • External rotation
   • Extension
   • Abduction
2. Initiate independent home motion
   • Home exercise program – AAROM for external rotation, wall climbs

Phase 3

Weeks 10-12

1. Continue motion as needed
2. Begin Cuff Strengthening when approved
3. Progress to overhead resistance with proper scapulohumeral rhythm
4. Avoid external rotation, 90/90, or throwing position

Week 13+

1. Advance activity
   • Swimming (avoid extreme abduction/external rotation)
   • Begin throwing program progression if approved
   • No contact or at risk activities/sports until 6 months

6 Months

1. Return to regular activity
2. Maintenance Program
   • Daily Stretching (all planes)
   • Strengthening 2-3 times / week