Shoulder and Elbow

Shoulder Stabilisation Postoperative Protocol

Week 0-2

Aim
Protect the anatomic repair
Diminish pain and inflammation

Sling full time 6 weeks / Shoulder shrugs /Ice packs
Hand, wrist, elbow ROM exercises

Week 2-6

Aim
Allow healing of wound and soft tissue
Protect the repair
Prevent shoulder stiffness

Add pendulum exercises
No external rotation beyond neutral
Isometric exercises in zero abduction.

Week 6-12

Aim
Achieve full ROM
Begin light strengthening
Dynamic shoulder stability
Gradual return to functional activities

Discard Sling
Active / active assisted ROM exercises
ER beyond neutral at 8 weeks
IR to body/chest
Graduated strengthening -isometrics , progress to isotonic
At 10 weeks: forward punch, seated row, shoulder shrug, lat pull downs (with elbow in front )
Scapular stabilizer strengthening
No abduction with external rotation for 12 weeks

Week 12-16

Aim
Maintain ROM
Gradual restoration of shoulder strength, power, and endurance
Dynamic shoulder stability

Continue stretching
Dynamic stabilization exercises
Continue and advance strengthening


Week 16 +

Aim
Maintain full non‐painful AROM
Advanced conditioning exercises for enhanced functional use
Improve muscular strength, power, and endurance
Gradual return to full functional activities

Continue stretching and strengthening
May start light throwing / soft toss program
May return to light sports: golf, tennis, swimming
At week 20, may initiate interval sports program
At week 24, may return to full sport activity if no pain or stiffness
No return to contact sports for 9 months.