The intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient that has undergone an arthroscopic Anterior Stabilization procedure (Bankart Repair). It is not intended to be a substitute for one’s clinical decision-making regarding the progression of a patient’s postoperative course based on their physical exam/findings, individual progress, and/or the presence of post-operative complications. If a clinician requires assistance in the progression of a postoperative patient, they should consult with Dr. Roe.
Phase I – ACUTE (0-6 Weeks):
Goals: Protect repair and manage symptoms.
Range of Motion (ROM): *No aggressive stretching ER or flexion.
- 0-2 weeks - Flex: 75, ER: 15, IR: 0 (scapular plane).
- 2-4 weeks - Flex: 110, ER: 35, IR: 30 (scapular plane).
- 4-6 weeks - Flex: 150, ER: 55, IR: Full (scapular plane).
Sling use:
- 0-4 weeks - for comfort and use outside of home.
- 4+ weeks - DC per MD.
Strengthening and conditioning:
- 0-2 weeks -
- Active elbow, wrist, hand ROM.
- Biking and elliptical (in sling).
- 2-4 weeks -
- Light 3–way isometrics at 0 (flexion, ABD, EXT).
- Scapular retractions and bent over rows.
- Lower extremity strengthening (in sling).
- 4-6 weeks -
- Light band rows (no extension past midline).
- Resistance band IR and ER exercises.
- Lower extremity strengthening (lunges, squats).
- Ladder drills, slide board (in sling).
Criteria for progression:
- Time: 6 weeks post-op.
- < 2/10 pain.
- DC sling per MD.
Phase II – INTERMEDIATE (6-12 Weeks):
Goals: Progress overhead ROM, normalize joint mobility, and enhance UE strength.
Range of Motion (ROM): *No aggressive stretching ER or flexion.
- 6-8 weeks: progress flexion to symmetry and ER to 60 (at side).
- 8-10 weeks: progress overhead flex / ER (at 90/90).
- 10-12 weeks: near-full symmetry (subtle deficits are normal).
Strengthening and conditioning:
- 6-8 weeks -
- Resisted rows, shoulder extension.
- Internal rotation band strengthening.
- 8-10 weeks -
- Progressed resisted rows, extensions, ER.
- Light resisted internal rotation.
- Resisted biceps and triceps.
- Lower extremity strengthening (lunges, squats).
Criteria for progression:
- Time: 12 weeks post-op for healing.
- 0–10 pain.
- > 90% ROM symmetry.
- 70% ER and IR strength symmetry.
- 80% symmetry for ER and IR endurance test.
Phase III – PLYOMETRICS AND POWER (12-20 Weeks):
Goals: Introduce plyometrics and power movements, initiate throwing program, progressive strengthening.
Range of Motion (ROM):
- 12+ weeks: near-full symmetry (subtle deficits are normal).
Strengthening and conditioning:
- 12-16 weeks -
- Initiate light dumbbell pressing.
- Push-up progression (wall 🡪 full).
- Trampoline ball tosses.
- 16-20 weeks -
- Progressed resisted rows, extensions, ER.
- Light resisted internal rotation.
- Resisted biceps and triceps.
Throwing and conditioning:
- 16+ weeks: Initiate interval throwing program (MD approval).
- 16–20+ weeks: Full LE strengthening, plyometric and agility.
Criteria for progression:
- 0/10 pain
- ER and IR strength symmetry > 80% normal.
- > 66% ER/IR strength ratio.
- > 90% symmetry – ER and IR endurance test.
- > 90% symmetry – seated shotput test.
Phase IV – RETURN TO PLAY (20+ Weeks):
Goals: Initiate sport-specific activities and return to play.
Strengthening and conditioning:
- 20+ weeks -
- Plyo tosses double and single-arm, overhead tosses.
- Closed chain strengthening.
- Full gym workouts for biceps and triceps.
Throwing and conditioning:
- 16-20+ weeks: Full LE strengthening, plyometric and agility.
- 20+ weeks: Initiate mound progression (MD approval).
Recommended criteria for return to play:
- 0/10 pain.
- ER and IR strength symmetry > 90% normal.
- > 66% ER/IR strength ratio.
- > 95% symmetry – ER and IR endurance test.
- > 95% symmetry – seated shotput test.
- > 1 minute for upper extremity close kinetic chain stability test.
- MD approval.