SPORTS MEDICINE / SHOULDER SERVICE

GEORGETOWN UNIVERSITY MEDICAL CENTER

Bankart Rehabilitation Protocol

(Arthroscopic or Open)

 

 

John J. Klimkiewicz, MD

 

 

 

Stage I  (0-3 weeks for open repair;  0-4 weeks for arthroscopic repair)

 

A.                  Shoulder sling placed in O.R.  May remove sling for dressing and hygiene.  Wear shoulder sling for 3  weeks for open repair; 4 weeks for arthroscopic repair.  May remove sling for tabletop activities within pain tolerance such as eating, brushing teeth, writing, and occasional keyboard use.  May also remove for exercises, showering, and dressing.  This may be modified  for individual patients and will be specified with accompanying  prescription.

 

B.            Exercises  :             ROM elbow, tennis ball for grip, co-contracture for biceps/triceps @ 0o, 30o, 60o,90o, 120o, and pendulum exercises.

 

 

 

Stage II  (4-12 weeks)

 

 

A.                  Start P.T.  at 4 weeks post-op

1 visit per week for isometric exercises and wand program

scapular stabilization exercises

 

 

B.                   ROM

1.)      AROM/PROM for all shoulder motions.

EXCEPT -  No ER past 20 until 4-6 weeks post-op.  Full ER by 12 weeks.  Progress as tolerated

 

                2.) IR/ER exercises at 5 weeks post-op against gravity--    No Isometrics

 

                3.)Home program:  Overhead pulleys if needed  and wand exercises.

 

 

ROM GOALS

 

WEEKS

Forward Flexion

External Rotation

0-2

90o

10o

2-4

110o

20o

4-6

130o

30o

6-8

160o

45

8-12

Full

Full**

 

**  Prefer 5o  less than normal side

 

 

 

C.                   Strengthening Exercises

 

1.)  Isometric exercises        start at 4 weeks post-op

                                                                NO IR or adduction until 6 weeks post-op

                                                                Reps:  7-10 x 10 seconds each – progress to 30 x 10 seconds each

                                                                Pain-free only

                2.)  Isotonic exercises        start at 6 weeks post-op

                                                                start against gravity only – progress as tolerated to :

 

                                                                4 oz. (butter knife)

                                                                8 0z. (tuna can)

                                                                1 lb weight  (soup can)

                                                                2 lb weight etc.

GOAL:                                  Thrower/pitcher:  5-8% body weight x 50 reps

                                                General rehab candidate:   1-3 % body weight x 25 reps

 

 

 

 

Stage III   (3-6 months)

 

 

A.                                          Overhead lifting/ traction activities as tolerated at 4 months

B.                                           Calisthenic exercises

 

 

1.        No pull-ups until 4 months post-op

2.        Throwing activity -  start at 4 months post-op.  Follow function progression  per IAM program.  Progress as tolerated.

3.        Return to sport at 4 months post-op if  PT goals have been met

4.        No dips – until 4 months

5.        Full return to throwing  at 6-8 months

 

 

 

 

 

 

This protocol provides general guidelines for the rehabilitation of the Bankart shoulder patient.  Specific changes in the program will be made to this protocol as appropriate for the individual patient  and will be specified on the accompanying prescription.  If  you have any questions regarding this protocol feel free to contact the physician at (202) 444-8613.