Bankart Repair

Patient may progress to each phase as long as all goals met from previous phase.  Please notify Dr Borque’s team if patient unable to perform any items specified.

Phase 1 (Weeks 0-6):

Focus is on protecting the repair, gentle motion and patient comfort

Sling weeks 0-4 when not doing exercises, then when outside of home or for comfort at 4 weeks

ROM: Caution to avoid any aggressive stretching especially in ER, ABD, and Flexion

  • Week 0-2: gentle flexion to 70, No ER or IR
  • Week 2-4: Flexion to 100, No ER, IR to 30 (SP)
  • Week 4-6: Flexion to 150, ER to 30 as tolerated, IR to full (SP)

Therapeutic exercise:

  • Week 0-2: elbow hand and wrist ROM 
  • Week 2-4: Minimal effort isometrics at 0 degrees (ABD, FF, ER), unresisted scapula retractions and shoulder shrugs
  • Week 4-6: LIGHT band rows, shrugs, ER and IR within motion limits.  May also begin light lower body exercises and stationary bike in sling 

Phase 2 (Weeks 6-12):

Focus on gradual progression of ROM while protecting repair

ROM:

  • Week 6-8: Advance FF and IR to symmetry as tolerated. ER to 60 with arm at side
  • Week 8-10: Can progress ER to symmetry at side and can begin ER at 90 ABD, advancing as tolerated
  • Week 10-12: advance to full symmetry in all planes

Therapeutic exercise:

  • Weeks 6-8: gradual progression from light bands with resisted rows, ER and IR with arm at side and within motion limits, and begin resisted shoulder extension
  • Weeks 8-12: continue gradual progression of the above with no motion restriction and begin resisted biceps and triceps

Other Exercises:

  • Week 6-10: May begin jogging, light agilities,  and lower body strengthening that can be done without using UE’s to stabilize weight  (leg press, etc)
  • Week 10-12: can begin sprinting and advanced agility work.  Can begin lunges holding light dumbells and light kettle bell squats

Criteria to advance to Phase 3:

  • 12 weeks post op
  • Motion near symmetry (90%+)
  • ER/IR strength and endurance test at 80% normal

Phase 3 (weeks 12-20):

ROM: Continue to advance to symmetry in all planes

Therapeutic exercise:

  • Week 12-16: Continue RTC and scapular stabilization strengthening.  Can begin light dumbbell presses on flat bench.  Multi-level rows. 
  • Week 16-20: Continue the above as tolerated and can begin light incline dumbbell presses as long as no discomfort.  

Throwing:

  • Week 16: can begin ITP with physician approval

Other Exercises:

  • Week 16: Can initiate light lower body strengthening exercises utilizing UE’s to stabilize weights (barbell squats, etc) as long as no discomfort.  May also begin light plyometrics.

Criteria to advance to Phase 4:

  • 20 weeks post op
  • ER/IR strength and endurance testing 90% normal
  • 66% ER/IR strength ratio

Phase 4 (week 20+): Return to play

  • Advance all upper and lower body gym strengthening as tolerated
  • Continue ROM and stretching exercises
  • May begin full plyometrics and continue advanced agility work
  • Return to mound work after successful completion of ITP and with physician approval
  • Goal for strength and ER/IR endurance testing at >95% normal