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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