Anterior Stabilization/Bankart Repair

Precautions: Avoid combined ER/ABDUCTION. At 10 weeks, if the patient needs combined

ER/Abduction, call physician for permission to begin this activity. Avoid resisted ER. All advanced
exercises need to follow the phase ROM restrictions. remplissage

*If remplissage procedure is performed, use this same protocol, but progress at a slower rate, per
patient tolerance. Follow physician’s special instruction and contact physician with any questions.

Phase I (1 – 5 days post-op)

 Goals:
o Maintain integrity of the repair
o Gradually increased PROM
o Diminish pain and inflammation
o Prevent muscular inhibition
 Wound care: Monitor surgical site
 Modalities: prn for pain and inflammation (ice, IFC)
 Sling: Ultrasling to be worn continuously except in therapy or during exercise sessions
 ROM: AROM of elbow, wrist, and hand. NO PROM

Phase II (5 days – 4 weeks post-op)

 Wound care: Monitor site/scar management techniques

 Modalities: prn for pain and inflammation (ice, IFC)
 Sling: Unitl 4 weeks, Ultrasling to be worn continuously except in therapy and during exercise
sessions. Until 6 weeks, continue to wear sling outdoors or in public settings.
 ROM:
o At 2 weeks AROM/PROM:
 Flexion: to 120 degrees
 Abduction: to 90 degrees
 ER/IR: in scapular plane (no pain or resistance); at 0 degrees of abduction to 30
degrees
 Exercises:
o At 2 weeks:
 Pendulum exercises 4-8 times daily in flexion and cirlces
 Scapular retraction with NO resistance
o Elbow, wrist, and hand AROM
o Fitness exercises limited to recumbent bike
o Sub-max and pain free isometrics (elbow bent) at 25% effort

Initiation Date: 6-7-04 Revised Date: 4-1-07, 11-14-08, 8-20-14

324 Roxbury Road * Rockford, IL * Phone (815) 484-6990 * Fax (815) 484-6961
 o UBE at low resistance
o GH joint mobilizations grade I/II for pain control

Phase III (4 weeks – 10 weeks post-op)

 Goals:
o Allow healing of soft tissue
o Do NOT overstress healing tissue
o Gradually restore full PROM (week 4-10) and AROM (week 6-10)
o Decrease pain and inflammation
 Modalities: prn for pain and inflammation (ice, IFC)
 Sling:
o At 4 weeks, D/C sling use of home.
o Until 6 weeks, sling must continue to be worn outdoors or in a public setting. D/C sling
at 6 weeks
 ROM:
o At 4-6 weeks:
 Gradually progress PROM/AROM to WNL’s for patient by 10 weeks
 Strengthening:
o Beginning at 4 weeks:
 50% effort for isometric exercises, with elbow at 90 degrees of flexion
o At 6-10 weeks:
 Progress to resisted strengthening and light theraband (avoid combined
abduction/ER )
 At 8 weeks, initiate body blade and rhythmic stabilization

Phase IV (10+ weeks post-op)

 Goals:
o Full AROM in all planes
o Full strength to enable return to work/sport
o Good scapular-humeral rhythm (may use biofeedback)
o 80-90% normal strength
 ROM:
o Avoid combined ER/Abduction unless athlete needs this specific ROM for sport or
patient lacks significantly behind ROM goal for the stage (contact physician PRIOR to
beginning ER/Abd combo)
 Strengthening:
o Advance as tolerated all shoulder musculature
 Can include plyometric and proprioceptive training routines
Initiation Date: 6-7-04 Revised Date: 4-1-07, 11-14-08, 8-20-14
324 Roxbury Road * Rockford, IL * Phone (815) 484-6990 * Fax (815) 484-6961
  At 10 weeks, 2 handed plyometrics
 At 12 weeks, progress to single handed plyometrics

Phase V (16+ weeks post-op)

 Athletes can begin a return to throwing program (contact physician PRIOR to beginning
throwing program)
 Gradual resumption of supervised sport specific exercise (contact physician PRIOR to beginning
throwing program)
 Return to non-contact sports possible for some athletes by 3 months
 Contact/collision sports after 6 months, if patient is compliant
 Max medical improvement for athletic activities by 12 months post-op
 No weight training until 8 months

Adapted From:

1) Brotzman SB, Wilk KE. Clinical Orthopedic Rehabilitation Second Edition. Philadelphia: Mosby;
2003.
2) Wilk KE, Reinold MM, Andrews, JR. Rehabilitation Following Arthroscopic Anterior Shoulder
Plication in the Overhead Athlete. Winchester MA: Advanced Continuing Education Institute,
2004.

Initiation Date: 6-7-04 Revised Date: 4-1-07, 11-14-08, 8-20-14

324 Roxbury Road * Rockford, IL * Phone (815) 484-6990 * Fax (815) 484-6961