The Shoulder Surgeon | Specialist keyhole surgery for the treatment of shoulder and elbow problems

The Shoulder Surgeon | Specialist keyhole surgery for the treatment of shoulder and elbow problems
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Common Shoulder Injuries
 

Shoulder Problems

 

Anterior stabilisation Protocol (Bankart repair/Laterjet)

The protocols should be goal orientated focusing on what the patient can achieve with ease and good quality movement / technique. The times are a guideline to allow you assess the patient’s progress.

Please note that this is the protocol for the patients having different shoulder procedures.

I have to stress the fact that this protocol applies to most patients but not all. Please refer to operation notes for any special instructions. If there are no special instructions you may follow these protocols.

If for whatever reason you are concerned please do not hesitate to contact me. If you can’t contact me please contact a doctor, preferably from my team.

Thank you.

 

Post op
Action
Day of Op
  • Axillary hygiene
  • Finger, wrist and elbow exercises
  • Teach how to remove sling and replace it safely before discharge

Day 1 – 3 /52

  • Polysling with body band for 3 weeks
  • Closed chain active assisted flexion to 90° (e.g. hands on table and walk away)
  • Active assisted ER in pain free range with good quality movement (max 30°)
  • Closed chain abduction in scapula plane (i.e. bilateral dusting table in diagonal pattern)
  • Core Stability and postural re- education

3 - 6 /52

NB: PATIENT SHOULD  ONLY FEEL A MILD STRETCH WITH EX, DO NOT FORCE

  • Body belt removed and sling worn outside clothes begin weaning off sling from 5/52 depending on patient ability
  • Progress to active flexionas comfortable with good humeral scapular rhythm and movement initiated from the hand not scapula
  • Active assisted abduction as comfortable with no external rotation and in scapula plane
  • Active external rotation as comfortable
  • HBB as able as comfortable
  • Progress core stability and proprioception

6 - 12 /52

  • Remove Polysling
  • Continue core stability & proprioceptive retraining
  • Strengthen throughout ROM using activity / work / sport specific exercises
  • Ensure good recruitment of rotator cuff through range especially posterior cuff
  • Use manual techniques if required for  persistent tightness

 

Note: Please avoid composite movements, especially external rotation with shoulder abduction for 8/52