Shoulder instability post Latarjet Procedure

Acute phase (0-4 weeks)​

Goals

  • Protect surgical repair

  • Reduce pain

  • Commence controlled shoulder range of movement

  • Promote improved proprioceptive acuity

Rehabilitation

  • *Safe zone: aim for passive range of movement to 90° elevation, 45° abduction, 0° external rotation by end of second week

  • Active assisted/supported range from 2 weeks

  • No forced movements, no combined aduction/external rotation

  • Closed kinetic chain/proprioception exercises

  • Cuff exercises within safe zone

  • Scapular setting exercises

  • Elbow, wrist, hand exercises

  • Criteria for progression

  • Controlled pain

  • Adequate range of movement (need adequate rotational range of movement before introducing active through range cuff facilitation work above 90°)

  • Compliance with exercises

Intermediate phase (4-8 weeks)

Goals

  • Discard sling

  • Restore functional range of movement

  • Re-educate cuff recruitment and scapular control through range

  • Enhance proprioception

  • Preserve surgical repair integrity

Rehabilitation

  • No passive stretching into combined abduction/external rotation

  • Encourage active movement with good control and without apprehension

  • Engage cuff and scapular stabilisation

  • Progress cuff and scapular recruitment through range

  • Progress kinetic chain integration

  • Closed kinetic change work

  • Hydrotherapy permitted

Criteria for progression

  • Painfree functional range of movement

  • Good cuff and scapular control through functional range

Late phase (>8 weeks)

Goals

  • Restore full range of movement

  • Optimise preparatory and reactive stabilisation

  • Optimise cuff and scapular control under load

  • Enhance shoulder power, strength and endurance

Rehabilitation

  • Regain optimal range of movement into combined positions

  • Enhance neuromuscular control through range and incorporated with kinetic chain

  • Strengthening and endurance exercises for cuff and scapular musculature

  • Preparatory and reactive stabilisation drills in risk positions

©2020 Kemble Wang Orthopaedics

 

Disclaimer: All information provided on this webpage should be considered as general guidelines. Actual practice and (expected) outcomes may differ in your case. The contents has been created online for information purposes only. It is not intended to be a substitute for professional medical advice.