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

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Phase 1

Sling

1. Full time for weeks 0-6, abduction pillow is optional, trough is required.

Weeks 0-6

1. NO RESISTED BICEPS (Includes Elbow Flexion & Forearm Supination)
2. Begin active shoulder motion in all planes
3. Hand and wrist active motion
4. Initiate independent home motion with caregiver — Home exercise program – Consider pendulums, wand exercise for external rotation
5. Active rotator cuff and scapular motion (shrugs, retraction, protraction)
6. Passive motion with biceps ok, no resistance or repetitive use

Phase 2

Weeks 7- 11

1. Begin Active Biceps
2. Continue to advance shoulder to full active motion (all planes)
3. Continue facilitating scapular stability
4. Emphasize continued independent home stretching to maintain motion
5. May begin low-level cuff strengthening after full AROM has been obtained
6. NO RESISTED BICEPS

Phase 3

Week 12

1. Begin PRE’s for biceps, advance cuff and scapular resistance as tolerated
2. Return to regular activity as tolerated
3. Maintenance Program
• Daily Stretching (all planes)
• Strengthening 2-3 times / week