Duration
  • Treatment after surgical repair is about 12 weeks in duration.
  • Patient can expect to return to work within 1-2 weeks after surgery if they have a sedentary job.
  • If patient’s job requires heavy lifting or sustained overhead positions, it may take up to 6-8 weeks before they can return.
  • Return to driving typically occurs once the sling is removed around 4-6 weeks.
  • No contact sports until at least 6 months post-operative
    • According to Stein et al article, the athletes in the study returned to sport within 6.5 +/- 1 .0 months

Protocol

0-2 weeks
o sling with abduction pillow
o PROM
  • Flex: 90* with no ER
  • Scaption: 45*
  • IR: 60*
  • ER, ABD, and EXT: 0

2-4 weeks
o sling with abduction pillow
o PROM
  • Flex: up to 120*
  • Scaption: 45*
  • IR: 60*
  • ER: 30* (in 20* of scaption)
  • Abd and Ext: 0

4-6 weeks
o sling with abduction pillow
o PROM
  • Flex: 120*
  • Scaption: 90*
  • IR: full
  • ER: 45* (in 20* of scaption)
  • Abd and Ext: 0

6-8 weeks
o sling is discontinued or as instructed by doctor
o PROM
  • Flex and scaption: progress to full
  • IR: full
  • ER: 60* in 45* scaption
  • Abd: progress to 90*
  • Ext: 20*

8-12 weeks
o PROM
  • Progress all directions toward full

Exercises

0-2 weeks
o AROM elbow, wrist, hand
o Scapular Stabilization
  • Shrugs
  • Scapular Retraction with no GH Ext
o Pendulum
  • PROM limitations
o Table walks
  • Flex within PROM limitations

2-4 weeks
o Continue with therapeutic exercises
o Begin Isometrics: flex, ER, IR, Ext with glenohumeral in neutral

4-6 weeks
o Begin AAROM: within ROM limitations
  • Pulley: Flex
  • T-bar: Flex
o Begin Closed Chain/proprioceptive training

6-8 weeks
o Scapular Stabilization
  • Rows with theraband within ROM limits
  • Wall Push-up
o Resistive Exercise with theraband
o Proprioceptive training
  • Quadraped

8-10 weeks
o Progress Scapular Stabilization exercises
o AAROM
  • Pulley and t-bar to gain full ROM in all directions
o Resistive Exercises
  • Deltoid
  • Rotator Cuff
  • Biceps
  • Triceps
o Proprioceptive Training
  • PNF
  • Body Blade
  • Box/step walking
  • Quadraped
o Plyometrics

10-12 weeks
o Scapular Stabilization
  • Chair dips
  • Plank
o Resistive
  • Upright row Military
  • press with dumb bell
o Plyometrics
  • Begin light throwing

References
http://www.sportmed.com/pdf/BankartRepair.pdf

http://www.liverpoolshoulder.co.uk/article.asp?article=6&section=2

Stein, T et al. (2011). Shoulder Sport-Specific Impairments After Arthroscopic Bankart Repair: A Prospective Longitudinal Assessment. American Journal Of Sports Medicine, 39(11), 2404-2414. doi:10.1177/0363546511417407