Rehabilitation Protocol

Shoulder Stabilization (Bankart Repair / Latarjet)

Protocol Overview

This protocol guides rehabilitation following surgical stabilization for shoulder instability. The primary goal is protecting the repair while restoring motion and strength. The protocol differs slightly between Bankart repair (arthroscopic labral repair) and Latarjet procedure (bone block). Avoiding positions of instability (abduction + external rotation) early is critical.

Important: This protocol is provided as a guideline. Always follow the specific recommendations from Dr. Joshi and your physical therapist, as modifications may be necessary based on your individual surgery and healing progress.

Phase 1

Protection Phase

Weeks 0-4

Goals

Protect the surgical repair
Control pain and swelling
Maintain elbow, wrist, and hand mobility

Exercises

Pendulum exercises
Elbow, wrist, and hand range of motion
Grip strengthening
Gentle scapular mobility

Precautions

Sling at all times
No external rotation past neutral
No abduction
No extension
No active shoulder motion

Criteria for Next Phase

Pain controlled
Wound healed
Compliance with precautions

Phase 2

Early Motion

Weeks 4-8

Goals

Begin protected range of motion
Gradually restore flexion and internal rotation
Carefully progress external rotation

Exercises

Passive/active-assisted forward flexion
ER progression: Week 4-6: 0-30°, Week 6-8: 30-45°
Active-assisted IR
Scapular exercises
Light isometrics (except ER)

Precautions

Progress ER slowly per protocol
Avoid combined abduction + ER
No resisted ER
Sling between exercises until Week 6

Criteria for Next Phase

Flexion 120°+
ER 45° (at side)
Good pain control

Phase 3

Progressive Strengthening

Weeks 8-12

Goals

Restore full range of motion
Begin strengthening program
Improve dynamic stability

Exercises

Progress ROM to full
ER/IR strengthening with resistance bands
Rotator cuff program
Scapular strengthening
Rhythmic stabilization
Closed kinetic chain exercises

Precautions

Gradually progress into functional ROM
Monitor for any instability symptoms
Controlled strengthening progression

Criteria for Next Phase

Full ROM
No apprehension
Good strength base

Phase 4

Advanced Strengthening & Return to Sport

Weeks 12-24

Goals

Full strength
Return to sports and activities
Sport-specific training

Exercises

Advanced strengthening exercises
Plyometric program
Sport-specific drills
Interval throwing program (if applicable)
Contact preparation (if applicable)

Precautions

Gradual return to sport
Full clearance before contact sports
Monitor for any instability symptoms

Criteria for Next Phase

Strength equal to opposite side
No apprehension with provocative positions
Completed sport-specific rehabilitation

Return to Activity Guidelines

Driving: 4-6 weeks
Desk work: 1-2 weeks (with sling)
Swimming (freestyle): 3-4 months
Golf: 4 months
Tennis: 4-6 months
Non-contact sports: 3-4 months
Contact sports (football, hockey, wrestling): 6 months minimum
Throwing sports: 4-6 months

All return to activity timelines are estimates and require clearance from Dr. Joshi based on your individual progress.

Questions About Your Recovery?

Contact our office or discuss with your physical therapist if you have questions about your rehabilitation.

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