Postoperative Shoulder Rehabilitation Protocol

An arm sling was used by the patients for 6 weeks postoperatively with the shoulder in 30° abduction and 30° external rotation. The postoperative rehabilitation program consisted of 3 phases. The first phase (0-6 weeks) was the maximal protection stage, in which the main goals were minimizing pain, protecting the integrity of the repair and restoring pain-free passive range of motion (PROM). Active range of motion (AROM) exercises of the elbow, wrist, hand, and cervical spine were started immediately, and PROM of the shoulder in postoperative week 3. The second phase (6-12 weeks) was the AROM stage. The main goals of this stage were restoring functional AROM and proprioception, encouraging use of the operative upper extremity for light activities of daily living and successful weaning from the orthosis. Active assisted range of motion and AROM exercises were initiated in supine and side-lying positions, then progressed to antigravity positions as appropriate. The third phase was the strengthening stage with the main goals of regaining muscle strength and shoulder stability and enhancing optimal PROM/AROM.