Upper Extremity

Use the links below to obtain PDF’s of the Sports & Orthopaedic Specialists Upper Extremity Physical Therapy Protocols. Our protocols draw evidence from the current literature and account for preferences of the providers at Sports & Orthopaedic Specialists. The protocols may be modified by the referring provider for an individual patient. If questions arise regarding the utilization of the protocols or the progress of a specific patient, contact Sports & Orthopaedic Specialists.

 

Click here to go to the Operative Shoulder & Elbow Protocols Below

For information about Return to Activity, click here.

For more information on shoulder/elbow anatomy and injuries check out our Upper Extremity Center.

 

GENERAL UPPER EXTREMITY EXERCISES

 

Therapeutic Exercise Handout | PDF

Four Corner Stretch | PDF

Codman / Pendulum Exercise | PDF

Supine Program: Rotator Cuff Focus | PDF

Supine Program: Deltoid Focus | PDF

Rotator Cuff Strength / Conditioning | PDF

Scapular Stabilization | PDF

 

CONSERVATIVE SHOULDER & ELBOW PROTOCOLS

Principles for the Management of Non-operative Shoulder Conditions

- Focus on active engagement of the patient through patient education and therapeutic exercise.  Establish a home exercise program that can be progressed as symptoms decline. 

- Home exercise program should result in minimal to no symptom exacerbation.  Max pain of 3/10 during and after exercise.  Differentiate pain from fatigue.  Patient should call the PT for recommendations if pain increases during or after exercise. 

- The main goal of physical therapy is to develop functional strength via improved neural recruitment and motor control.  

- Consider local tissue irritability in decision making when determining intervention.  Use caution to avoid post-treatment tissue inflammation and associated pain. 

- Use body weight against gravity and light free weights for resistance.  See protocols for specifics regarding weight maximums.  No theraband.  No pulleys. 

 

Impingement Syndrome | PDF

Rotator Cuff Tear | PDF

Massive Rotator Cuff Tear PDF

Adhesive Capsulitis PDF

Anterior Instability PDF

Multi-Directional Instability & Swimmer's Shoulder PDF

Posterior Instability PDF

UCL Injury | PDF

Lateral & Medial Epicondylitis PDF

 

OPERATIVE SHOULDER & ELBOW PROTOCOLS

Principles for Post-operative Shoulder Rehabilitation

- Adhere to postoperative precautions. 

- Respect tissue healing.  The surgeons at Sports & Orthopaedic Specialists uniformly prefer a slow progression of postop patients with minimal postoperative pain. 

- Postoperative pain may be experienced.  However physical therapy, including the home exercise program, should result in minimal to no symptom exacerbation.  The patient should call the PT for recommendations if pain increases during or after exercise. 

- The therapeutic exercises in the protocols convey the appropriate load for the shoulder given the time elapsed since surgery in regards to tissue healing.  It is acceptable for a patient to progress more slowly.  However, it is not acceptable for a patient to progress more quickly unless directly indicated by the surgeon. 

- Encourage patient use of ice until pain free or 8 weeks after surgery. 

- No manual therapy unless explicitly prescribed by the surgeon.  No passive range of motion.  No theraband.  No pulleys.  

 

Subacromial Decompression | PDF

Rotator Cuff Repair PDF

Massive Rotator Cuff Repair PDF

Biceps Tenodesis PDF

Anterior Labrum & Bankart Repair | PDF

Reverse Bankart Repair PDF

SLAP Repair PDF

Hemiarthroplasty PDF

Total Shoulder Arthroplasty PDF

Reverse Total Shoulder Arthroplasty PDF

Scapulothoracic Decompression PDF

Pectoralis Major Repair PDF

UCL Reconstruction | PDF

Lateral Epicondyle Release | PDF

Ulnar Nerve Transportation | PDF

Distal Biceps Repair | PDF

 

Click here to return to the Conservative Shoulder & Elbow Protocols Above