Bankhart+Lesion

__**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 o Pendulum o Table walks
 * Shrugs
 * Scapular Retraction with no GH Ext
 * PROM limitations
 * 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 o Begin Closed Chain/proprioceptive training
 * Pulley: Flex
 * T-bar: Flex

__6-8 weeks__ o Scapular Stabilization o Resistive Exercise with theraband o Proprioceptive training
 * Rows with theraband within ROM limits
 * Wall Push-up
 * Quadraped

__8-10 weeks__ o Progress Scapular Stabilization exercises o AAROM o Resistive Exercises o Proprioceptive Training o Plyometrics
 * Pulley and t-bar to gain full ROM in all directions
 * Deltoid
 * Rotator Cuff
 * Biceps
 * Triceps
 * PNF
 * Body Blade
 * Box/step walking
 * Quadraped

__10-12 weeks__ o Scapular Stabilization o Resistive o Plyometrics
 * Chair dips
 * Plank
 * Upright row Military
 * press with dumb bell
 * Begin light throwing

References []

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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