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REHAB PROTOCOL · SHOULDER

Shoulder Stabilization (Bankart) Rehab Protocol

By Dr. Shayne Kelly, DO — Fellowship-Trained Sports Medicine Surgeon · Tri-City Orthopedics, Kennewick, WA

The written protocol Dr. Kelly provides to his patients and their physical therapists in the Tri-Cities. Time frames are guidelines — progression is criteria-based, and your own post-op instructions always govern.

⬇  Printable protocol (PDF)Request an appointment →
Educational information, not medical advice. This is not a substitute for the specific instructions Dr. Kelly and your physical therapist give you. Your timeline depends on your surgery, your body, and your progress. Follow your own care team's directions. In an emergency, call 911.
0–4 Weeks
MAXIMAL PROTECTION PHASE
4–8 Weeks
MODERATE PROTECTION PHASE
8–12 Weeks
MINIMAL PROTECTION PHASE
3–12 Months
STRENGTHENING PHASE

0–4 WeeksMAXIMAL PROTECTION PHASE

  • •Sling Immobilization
  • •Protect anterior/posterior capsule from stretch, but begin passive ROM only POD 10–14
  • •Supine Forward Elevation in scapular plane to 90°; external rotation with arm at side to 30°.
  • •Grip Strength, Elbow/Wrist/Hand ROM; do NOT perform codmans; begin deltoid/Cuff isometrics
  • •May remove sling for shower but maintain arm in sling position; modalities PRN
GOALS  Protect the repair

4–8 WeeksMODERATE PROTECTION PHASE

  • •Discontinue Sling at 4–6 weeks as tolerated; advance to AAROM and AROM (Limit FF to 140°, ER at side to 40°)
  • •Begin with gravity eliminated motion (supine) and progress. Do not; force ROM with substitution patterns.
  • •Continue Isometric exercises; progress deltoid isometrics; ER/IR (submaximal) with arm at side
  • •Begin strengthening scapular stabilizers
GOALS  Progress motion

8–12 WeeksMINIMAL PROTECTION PHASE

  • •Advance to full, painless ROM. Gentle stretching at end ROM; initiate ER in 45° abduction at 10–12 weeks
  • •Full AROM all directions below horizontal with light resistance; deltoid/Cuff progress to isotonics
  • •All strengthening exercises below horizontal
GOALS  Full ROM, no apprehension

3–12 MonthsSTRENGTHENING PHASE

  • •Initiate when pain-free symmetric AROM; progress as tolerated
  • •Only do strengthening 3x/week to avoid rotator cuff tendonitis; restore scapulohumeral rhythm; joint mobilization.
  • •Aggressive scapular stabilization and eccentric strengthening program.
  • •Initiate isotonic shoulder strengthening exercises including: side lying ER,
  • •Prone arm raises at 0, 90, 120°, elevation in the plane of the
  • •Scapula with IR and ER, lat pulldown close grip, and prone ER; dynamic stabilization WB and NWB.
  • •PRE’s for all upper quarter musculature (begin to integrate upper extremity patterns). Continue to emphasize eccentrics and glenohumeral stabilization.
  • •All PRE’s are below the horizontal plane for non-throwers; begin isokinetics; begin muscle endurance activities (UBE).
  • •i. High seat and low resistance ii. Must be able to do active shoulder flexion to 90° without substitution
  • •3); continue with agility exercises; advanced functional exercises; isokinetic test; functional test assessment.
  • •Full return to sporting activities.
GOALS  Sport preparation

Return to Sport & Discharge Criteria

  • •Full pain-free ROM, including ER without apprehension
  • •Cuff and periscapular strength ≥90%; sport drills without instability
  • •Contact sport per Dr. Kelly (commonly ≥5–6 months); throwers complete an interval throwing program

Time frames are guidelines — progress when phase goals are met, per Dr. Kelly and the treating therapist.

Procedure variants — printable protocols

When to call

Increasing pain, numbness, redness, drainage from the wound, or fever/chills — call (509) 460-5588. After hours, the answering service can reach Dr. Kelly. If your issue feels emergent, call 911 or go to the nearest emergency department.

Physical therapists

Treating one of Dr. Kelly's patients? Download the printable protocol for your clinic, and call (509) 460-5588 with questions about an individual patient's progression.

⬇  Protocol PDF

Related protocols

SHOULDERRotator Cuff RepairSHOULDERReverse Total Shoulder ReplacementELBOWUCL Reconstruction (Tommy John)

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