PT Resources



0-3 Weeks

PROM limited to: 90 flexion, 90 abduction, 0 external rotation and 0
extension. Avoid hyperextension of elbow. Sling worn at all times to
support glenohumeral joint.
  • 1. PROM to tolerance within limitations
  • 2. Postural awareness education
  • 3. Sub-maximal isometrics for shoulder musculature-avoid forward elevations
  • 4. Theraputty and light resisted wrist isometrics
  • 5. Soft tissue mobilization as tolerated
  • 6. Ice/Cryocuff as needed
  • 7. Cardiovascular exercises-stationary bike, treadmill with arm supported

3-6 Weeks

ROM limited to: 120 flexion, 120 abduction, and 30 external rotation Wean from sling-no active arm swing until after 4 weeks
  • 1. PROM/AAROM (supine wand) to tolerance within limitations
  • 2. Gentle manual resistance for scapula motions
  • 3. Gentle rotator cuff strengthening
  • 4. Gentle joint mobilization to scapula

6-8 Weeks

ROM only limited to 60 external rotation
  • 1. Progress PROM within limitations
  • 2. AAROM/AROM within pain tolerance-seated wand, pulleys, UBE
  • 3. Initiate light resisted elbow flexion and extension
  • 4. Gentle open kinetic chain rhythmic stabilization exercises in supine

8-12 Weeks

ROM limited to 60 external rotation
  • 1. AROM with emphasis on quality of motion, avoid shoulder hiking with elevation
  • 2. Strengthening exercises for scapula stabilizers and rotator cuff May include PRE’s, eccentric rotator cuff, PNF (avoid heavy resistance in painful end ranges), and weight equipment Emphasis of strengthening on high reps and low weight, with postural awareness
  • 3. Progress closed kinetic chain exercises as tolerated
  • 4. Isokinetic at fast speeds blocking end ranges-avoid impingement
Goal: Full PROM (external rotation to 60) by 12 weeks

12-24 Weeks

No ROM limitations
  • 1. Progress to independent strengthening program

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