Dr. Mitchell W. Larsen MD
Director of Education
Central Utah Sports Medicine
1055 N 500 W Bld C Ste 121
Provo, UT 84604
(801)373-7350

ARTHROSCOPIC BANKART REPAIRS PROTOCOL

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MAXIMAL PROTECTION PHASE (0-4 WEEKS)

• ROM precaution – determined in OR

• Sling

• No passive or active shoulder motion

• Isometrics in the sling (in internal rotation)

• Active elbow and wrist exercise

• Active scapular exercises in neutral-shrugs, depression, protraction & retraction

MODERATE PROTECTION PHASE (4-6 WEEKS)

• PROM

• AAROM Exercises – Pendulum, supine flexion & ER (neutral/45º abduction) with uninvolved upper extremity or cane (flexion only)

• Sub-maximal shoulder isometrics

• Aquatics for ROM – shoulder submerged at all times.

MINIMAL PROTECTION PHASE (6-8 WEEKS)

• Full PROM by 8 weeks

• Progress from AAROM to AROM

• “Quality” movement only – avoid forcing active motion with substitution patterns

• Remember the effects of gravity on the limb, do gravity eliminated motions first, i.e. supine flexion with progressive introduction of gravity.

STRENGTHENING PHASE (8 WEEKS)

CRITERIA:

• Pain-free AROM

• Pain-free with manual muscle test

• Progress by response to treatment

• Initiate isotonic shoulder strengthening exercises including: sideling ER, prone arm raises at 0, 90 and 120°, elevation in the plane of the scapula with IR and ER, Lat pulldown close grip only if FROM achieved with proper biomechanics, and prone ER

• Progress scapulothoracic strengthening exercises

• Dynamic stabilization WB and NWB

• UBE – high seat and low resistance

*must be able to do active shoulder flexion to 90° without substitution*

• Progress to combine movement patterns PNF

FUNCTIONAL PHASE:

CRITERIA:

• No pain or point tenderness

• Full pain-free ROM

• Adequate strength for the activity (90% contralateral shoulder)

• Aggressive strengthening exercises for shoulder and scapular muscles

• Progress to functional activities needed for ADL’s and Sport

• Push-up progression

• Plyometric program

• Proprioceptive drills with basketball and plyoball