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Arthroscopic Posterior Stabilisation

Aims:                     

To stabilise posterior or multidirectional shoulder instability

 

Sling:                     

External rotation brace for 3 weeks- except washing and exercises

Normal poly-sling up to 6 weeks

Wean form 6 weeks

 

Restrictions:          

Avoid shoulder flexion, internal rotation and adduction for 6-8 week

Avoid axial loading of flexed shoulder for 3 months

 

0-3weeks:              

Check neurovascular status and post op note

Hand, wrist and elbow active motion

Gentle flexed pendulum exercises- up to 50 degrees

3-6 weeks:             

Continue pendulum exercises up to 80 degrees

Internal and external rotation to 20 degrees only

Push hand, elbow and wrist range of motion

Scapular setting in neutral

 

6-8 weeks:             

Wean from sling

Progress internal and external rotation to 50% of contralateral side

Aim for active assisted flexion to 120-140 degrees in scapula plane and external rot.

Avoid adduction in internal rotation

 

8-12 weeks:           

Start gentle rotator cuff strengthening

Scapula setting and control exercises

Progress active elevation exercises

 

From 12 weeks:     

Aim for full range of flexion

75 % of rest of contralateral range of motion

Push strengthening over range

 

Sports:                   

3 months-non contact sports (cycling, jogging, swimming- breast stroke)

6 months- return to contact and overhead sports

Work:                    

Sedentary jobs- as pain allows

Manual jobs- return 6-8 weeks and adjust for up to3 months

Driving:                  

8weeks depending on comfort

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