Penrose Physical Therapy
01
Jan 2016
Jennifer Penrose
Author
Jennifer Penrose
PHASE I: (WEEK 0-6)
  • Wear sling except for exercises and showering
  • NO AROM
  • Elbow & wrist ROM & grip strengthening
  • Start Codmans

WEEK 2:

  • AAROM in supine (wand)
    • FLEX to 90°
    • ABD to 90°
    • IR to belly
    • ER 30° @ neutral

WEEK 3:

  • Submaximal isometrics pain free, *Avoid ABD

WEEK 4:

  • PROM
    • FLEX to 135°
    • ABD to 135°
  • Pulleys AAROM
    • FLEX 90°-110°
    • ABD 90°-110°

WEEK 6:

  • Pt should have 75% of PROM compared to uninvolved side
PHASE II: (WEEKS 6-12)
  • D/C immobilizer
  • Regain full PROM through:
    • Stretching
    • Joint mobilizations
    • AAROM to AROM
  • Begin PNF
  • Begin PRE in painfree range
  • AVOID IMPINGEMENT

WEEKS 6-8:

  • Submaximal isometrics in all planes

WEEKS 8-10:

  • Begin theraband exercises
    • Start with IR & ER in neutral
    • Work toward FLEX & ABD to 90°
    • Then EXT & ADD

WEEKS 10-12:

  • Begin free weights
    • Start with standing FLEX, ABD
    • Side-lying ER
    • Supine IR
  • Hughston exercises started in prone
  • Emphasis on proper scapular stabilization and control

WEEK 12:

  • Patient should have full AROM and PROM with good scapular control
  • Adequate strength to perform pain free ADL’s
  • PT visits may decrease to 1-2x/month to progress home program
PHASE III: (3-6 MONTHS)
  • Aggressive stretching
  • Increase resistance strengthening program
  • Progress back to sports or more strenuous work related functional activities
  • General timeline:
    • 3-4 months to return to full activity
    • 9-12 months to reach full rehab potential
  • At 6 month follow up, hope to have 90% of strength compared to uninvolved side & pain free with activities

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