Physical Therapy Protocol - Advanced Orthopedic Associates

This subsection of our website contains rehabilitation programs or protocols designed for postoperative patients. The recommendations in these protocols should be followed closely. The exercises should be supervised by a knowledgeable physical therapist. If you experience problems with the exercise program, please notify our office.

Click on your rehabilitation protocol to download a PDF file containing specific exercises and instructions for each phase of your recovery. Please share these protocols with your physical therapist. If you are uncertain which protocol you should be following, then please call our office for clarification.

To view the videos of each exercise visit our Therapy Videos section. Not all exercises recommended in each protocol are demonstrated in the videos. We recommend that you rely on your physical therapist to demonstrate the exercises not shown on our website.

SHOULDER DEBRIDEMENT PROCEDURES

Protocol S1 – Physical Therapy Protocol for Arthroscopic Subacromial Decompression, Distal Clavicle Excision and Debridement

Phase I – Motion Phase (weeks 0-4): Review videos for passive ROM (Codman’s pendulum, passive flexion, stick-assisted flexion, stick-assisted extension, stick-assisted abduction, stick-assisted external rotation, stick-assisted internal rotation), active ROM, overhead pulley and isometric strengthening (flexion, extension, abduction, external rotation, internal rotation).

Phase II – Strengthening Phase (weeks 5-8): Review videos for shoulder stretching (supine stretch, wall climb, posterior capsular stretch) and isotonic strengthening (theraband preparation, flexion, extension, abduction, external rotation, internal rotation, shoulder shrugs, wall push ups).

Phase III – Full Activity Phase (weeks 9+): Consult with physical therapist for additional exercises.

Download the PDF HERE

Protocol S2 – Physical Therapy Protocol for Arthroscopic Capsulotomy and Debridement

Phase I – Motion Phase (weeks 0-4): Review videos for passive ROM (Codman’s pendulum, passive flexion, stick-assisted flexion, stick-assisted extension, stick-assisted abduction, stick-assisted external rotation, stick-assisted internal rotation), active ROM, overhead pulley, shoulder stretching (supine stretch, wall climb, posterior capsular stretch) and isometric strengthening (flexion, extension, abduction, external rotation, internal rotation).

Phase II – Strengthening Phase (weeks 5-8): Review videos for isotonic strengthening (theraband preparation, flexion, extension, abduction, external rotation, internal rotation, shoulder shrugs, wall push ups).

Phase III – Full Activity Phase (weeks 9+): Consult with physical therapist for additional exercises.

Download the PDF HERE

ROTATOR CUFF REPAIR PROCEDURES

Protocol S3 – Accelerated Physical Therapy Protocol for Rotator Cuff Repair (Arthroscopic or Mini-Open Technique)

Recommended for mild (≤ 1 cm) rotator cuff tear

Phase I – Protection Phase (weeks 0-4): Review videos for shoulder immobilizer and passive ROM (Codman’s pendulum, passive flexion, stick-assisted flexion, stick-assisted extension, stick-assisted abduction, stick-assisted external rotation).

Phase II – Motion Phase (weeks 5-8): Review videos for active ROM, overhead pulley, stretching (supine stretch, wall climb, posterior capsular stretch) and isometric strengthening (flexion, extension, abduction, external rotation, internal rotation).

Phase III – Strengthening Phase (weeks 9-12): Review videos for isotonic strengthening (theraband preparation, flexion, extension, abduction, external rotation, internal rotation, shoulder shrugs, wall push ups).
Phase IV – Advanced Strengthening Phase (weeks 13-26): Consult with physical therapist for additional exercises. Progress to sport-specific exercise program at 17+ weeks.

Phase V – Maintenance Phase (weeks 27+): Self-directed exercise program.

Download the PDF HERE

Protocol S4 – Standard Physical Therapy Protocol for Rotator Cuff Repair (Arthroscopic or Mini-Open Technique)

Recommended for a moderate (2-4 cm) rotator cuff tear

Phase I – Protection Phase (weeks 0-5): Review videos for shoulder immobilizer and passive ROM (Codman’s pendulum, passive flexion, stick-assisted flexion).

Phase II – Motion Phase (weeks 6-10): Review videos for active ROM, overhead pulley, stretching (supine stretch, wall climb, posterior capsular stretch) and isometric strengthening (flexion, extension, abduction, external rotation, internal rotation).

Phase III – Strengthening Phase (weeks 11-15): Review videos for isotonic strengthening (theraband preparation, flexion, extension, abduction, external rotation, internal rotation, shoulder shrugs, wall push ups).

Phase IV – Advanced Strengthening Phase (weeks 16-26): Consult with physical therapist for additional exercises.

Phase V – Maintenance Phase (weeks 27+): Self-directed exercise program.

Download the PDF HERE

Protocol S5 – Conservative Physical Therapy Protocol for Rotator Cuff Repair (Arthroscopic or Mini-Open Technique)

Recommended for a large to massive (≥5 cm) rotator cuff tear

Phase I – Protection Phase (weeks 0-6): Review videos for shoulder immobilizer and passive ROM (Codman’s pendulum, passive flexion).

Phase II – Motion Phase (weeks 7-12): Review videos for active ROM, overhead pulley, stretching (supine stretch, wall climb, posterior capsular stretch) and isometric strengthening (flexion, extension, abduction, external rotation, internal rotation).

Phase III – Strengthening Phase (weeks 13-18): Review videos for isotonic strengthening (theraband preparation, flexion, extension, abduction, external rotation, internal rotation, shoulder shrugs, wall push ups).

Phase IV – Advanced Strengthening Phase (weeks 19-26): Consult with physical therapist for additional exercises.

Phase V – Maintenance Phase (weeks 27+): Self-directed exercise program.

Download the PDF HERE

LABRAL REPAIR PROCEDURES

Protocol S6 – Physical Therapy Protocol for Repair of SLAP (Superior Labrum Anterior Posterior) Lesion

Phase I – Protection Phase (weeks 0-5): Review videos for shoulder immobilizer and passive ROM (Codman’s pendulum, passive flexion, stick-assisted flexion, stick-assisted extension, stick-assisted abduction, stick-assisted external rotation).

Phase II – Motion Phase (weeks 6-10): Review videos for active ROM, overhead pulley, and isometric strengthening (flexion, extension, abduction, external rotation, internal rotation).

Phase III – Strengthening Phase (weeks 11-16): Review videos for stretching (supine stretch, wall climb, posterior capsular stretch) and isotonic strengthening (theraband preparation, flexion, extension, abduction, external rotation, internal rotation, shoulder shrugs, wall push ups).

Phase IV – Advanced Strengthening Phase (weeks 17-26): Consult with physical therapist for additional exercises. Progress to sport-specific exercise program.

Phase V – Maintenance Phase (weeks 27+): Self-directed exercise program.

Download the PDF HERE

Protocol S7 – Physical Therapy Protocol for Arthroscopic or Open Bankart Repair

Phase I – Protection Phase (weeks 0-5): Review videos for shoulder immobilizer and passive ROM (Codman’s pendulum, passive flexion).

Phase II – Motion Phase (weeks 6-10): Review videos for passive ROM (stick-assisted flexion, stick-assisted extension, stick-assisted abduction, stick-assisted external rotation), active ROM, overhead pulley, and isometric strengthening (flexion, extension, abduction, external rotation, internal rotation).

Phase IV – Advanced Strengthening Phase (weeks 17-26): Consult with physical therapist for additional exercises. Progress to sport-specific exercise program.

Phase V – Maintenance Phase (weeks 27+): Self-directed exercise program.

Download the PDF HERE

Protocol S8 – Physical Therapy Protocol for Arthroscopic Reverse Bankart Repair or Open Posterior Capsulorrhaphy

Phase I – Protection Phase (weeks 0-5): Review videos for shoulder immobilizer and passive ROM (Codman’s pendulum, passive flexion). Remember to wear shoulder immobilizer at your side rather than out in front.

Phase IV – Advanced Strengthening Phase (weeks 17-26): Consult with physical therapist for additional exercises. Progress to sport-specific exercise program.

Phase V – Maintenance Phase (weeks 27+): Self-directed exercise program.

Download the PDF HERE

SHOULDER RECONSTRUCTION PROCEDURES

Protocol S9 – Physical Therapy Protocol for Coracoclavicular Ligament (AC Joint) Reconstruction

Phase I – Protection Phase (weeks 0-6): Review video for shoulder immobilizer.

Phase II – Motion Phase (weeks 7-12): Review videos for passive ROM (Codman’s pendulum, passive flexion, stick-assisted flexion, stick-assisted extension, stick-assisted abduction, stick-assisted external rotation, stick-assisted internal rotation) active ROM, overhead pulley, and isometric strengthening (flexion, extension, abduction, external rotation, internal rotation). Progress to isotonic strengthening.

Phase III – Strengthening Phase (weeks 13-18): Review videos for shoulder stretching (supine stretch, wall climb, posterior capsular stretch) and isotonic strengthening (theraband preparation, flexion, extension, abduction, external rotation, internal rotation, shoulder shrugs, wall push ups).

Phase IV – Advanced Strengthening Phase (weeks 19-26): Consult with physical therapist for additional exercises. Progress to sport-specific exercise program.

Phase V – Maintenance Phase (weeks 27+): Self-directed exercise program.

Download the PDF HERE

Protocol S10 – Accelerated Physical Therapy Protocol for Shoulder Replacement (Hemiarthroplasty or Total Shoulder Arthroplasty)

Phase I – Motion Phase (weeks 0-6): Review videos for shoulder immobilizer, passive ROM (Codman’s pendulum, passive flexion, stick-assisted flexion, stick-assisted extension, stick-assisted abduction, stick-assisted external rotation), active ROM, overhead pulley, and isometric strengthening (flexion, extension, abduction, external rotation, internal rotation).

Phase II – Strengthening (weeks 7-12): Review videos for shoulder stretching (supine stretch, wall climb, posterior capsular stretch) and isotonic strengthening (theraband preparation, flexion, extension, abduction, external rotation, internal rotation, shoulder shrugs, wall push ups).

Phase III – Maintenance Phase (weeks 13+): Consult with physical therapist for additional exercises.

Download the PDF HERE

Protocol S11 – Conservative Physical Therapy Protocol for Shoulder Replacement (Hemiarthroplasty or Total Shoulder Arthroplasty)

Phase I – Protection Phase (weeks 0-6): Review videos for shoulder immobilizer and passive ROM (Codman’s pendulum, passive flexion).

Phase II – Motion Phase (weeks 7-12): Review videos for active ROM, overhead pulley, anterior deltoid strengthening and isometric strengthening (flexion, extension, abduction, external rotation, internal rotation).

Phase III – Strengthening Phase (weeks 13+): Review videos for isotonic strengthening (theraband preparation, flexion, extension, abduction, external rotation, internal rotation, shoulder shrugs, wall push ups).

Download the PDF HERE

Protocol S12 – Physical Therapy Protocol for Long Head of Biceps Tenodesis

Phase I – Protection Phase (weeks 0-4): Use of shoulder immobilizer and passive range of motion exercises.

Phase II – Motion Phase (weeks 4-6): Begin active range of motion exercises.

Phase III – Strengthening Phase (weeks 6-12): Begin isotonic strengthening exercises with therabands.

Phase IV – Advanced Strengthening Phase (weeks 12-20): Consult with physical therapist for additional exercises. Progress to sport-specific exercise program.

Phase V – Maintenance Phase (weeks 20+): Self-directed exercise program.

Download the PDF HERE