Arthroscopic Anterior Stabilisation / Bankart Repair / Capsular Shift

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Aims:                     

Prevent anterior shoulder instability

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Sling:                     

Up to max of 6 weeks.

Aim to wean by 4 weeks depending on pain

Sling to be removed for exercise, washing and at rest

Teach axilla hygiene and washing out of sling

 

Restrictions:           

Avoid ABER position (abduction and external rotation) for first 12 weeks

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1-3 weeks:             

Check neurovascular status and operation note

Hand, wrist and elbow- full range of active motion

Shoulder shrugs

Teach axilla hygiene and washing out of sling

2-3 weeks- bent forward active assisted flexion to 90 degrees as pain allows (in IR)

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3-6 weeks:             

Passive and active assisted flexion- aim 50% of normal by end week 4

Push for full active assisted flexion end of week 6 as pain allows

Aim for 50% of normal ER by end week 6

Isometric cuff strengthening in neutral

Scapular setting in neutral

Closed chain exercises in neutral

 

6-12 weeks:           

Gentle strengthening as comfortable

Aim to achieve 75% of normal external rotation by week 12

If stiffness persists, consider gentle passive stretches

Active flexion, abduction and internal rotation

Closed chain exercises in to range

Check scapula control throughout ROM

Proprioception exercises when control improves

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From 12 weeks:     

Aim for full ROM with at least 75% of normal external rotation

Increase strengthening and add in gentle weights

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Sports:                   

3 months- non contact sports, cycling, jogging, breast stroke

6 months- contact sports

9 months- overhead sports

 

Work:                     

Sedentary jobs- return as pain allows

Manual jobs- may need to adjust activity for up to 3 months

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Driving:                  

From 8 weeks-pain and ROM dependent