The document is a structured, research‑backed rehabilitation protocol for patients who have undergone an anterior capsular shift surgery on the shoulder. It outlines a four‑phase postoperative program spanning roughly 30 weeks, each with explicit goals, precautions, brace recommendations, and detailed week‑by‑week exercise prescriptions. Phase I (Weeks 0‑8) focuses on protection, early passive/active assisted range of motion, isometrics, and pain control while the shoulder is immobilized. Phase II (Weeks 8‑14) advances to full non‑painful ROM, isotonic strengthening, and neuromuscular control drills for the glenohumeral and scapulothoracic joints. Phase III (Weeks 14‑22) is a dynamic strengthening phase that requires full ROM, no pain, and at least 70 % strength compared to the opposite side; it emphasizes power, endurance, and sport‑specific preparation. Phase IV (Weeks 22‑30+) prepares the patient for a functional return to sport or activity, with criteria for progression, interval sports programs, core stabilization, and endurance training. Throughout, the protocol stresses compliance, individualized brace use (sling or abduction brace), pain/inflammation management, and regular reassessment before advancing phases.
Topics
Program Overview and Clinical Rationale
Introduces the purpose of the protocol, its basis in muscle physiology, biomechanics, anatomy, and healing after capsular shift surgery, and emphasizes the importance of compliance for optimal outcomes.
Phase I – Protection Phase (Weeks 0‑8): Early Mobilization and Pain Management
Details goals (healing, protected ROM, prevent atrophy), brace selection, immobilization precautions, and week‑by‑week exercises ranging from wrist/hand work to pendulums, isometrics, rhythmic stabilization, and proprioception drills.
Phase II – Intermediate Phase (Weeks 8‑14): Restoring Full ROM and Neuromuscular Control
Outlines the target of non‑painful full ROM by weeks 10‑12, specific ROM milestones (e.g., 145‑150° flexion, 70° ER at 90° abduction), introduction of isotonic dumbbell strengthening, scapular and glenohumeral neuromuscular drills, and continued stabilization exercises.
Progression Decision Points and Clinical Milestones
Summarizes the objective criteria used to advance between phases, including ROM percentages, pain status, strength comparisons, and clinical exam findings.
Rehabilitation Principles and Adjunctive Care
Covers underlying principles such as muscle physiology, biomechanics, healing timelines, and adjunctive modalities for pain/inflammation control (ice, NSAIDs, modalities).