Arthroscopic Anterior Stabilisation

If combined anterior and posterior stabilisation, please use posterior stabilisation rehabilitation protocol..

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 abduction/external rotation
• Closed kinetic chain/proprioception exercises (ie. with ball)
• Cuff exercises within this range of movement 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 & scapular stabilisation
• Progress cuff & 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
• Ensure high level strengthening and endurance exercises for cuff/scapular musculature through range, particularly risk positions
• Preparatory and reactive stabilisation drills in risk positions

Guidelines for return to functional activities