M. Mardani Kivi (M.D) Guilan university of Medical sciences

Strengthening program of shoulder muscles has an effective role in non- operative management of shoulder instabilities.

Training tape is applied across the back of the shoulder as a reminder to avoid unbalanced positions.

Rehabilitation program after open anterior capsulo-labral reconstruction

Shoulder abduction pillow

Isometric abduction & Horizontal adduction

Ball squeeze

Rehabilitation program after open anterior capsulo-labral reconstruction

Shoulder shrugs / Resistance tubes Prone extension

Upper body ergometer

Rehabilitation program after open anterior capsulo-labral reconstruction

Chin-up

Throwing Programs

Codmans exercise Other names: pendulum exercise or Tic-Toc exercises Codmans exercises in performed by swinging the freely hanging upper extremity in a pendulous fashion and are assisted by gravity. Exercise have three parts: Circumduction or rotation Forward and backward movement Side to side movement

Rotation in codmans exercise Never use more than 3 lbs to 5 lbs additional weight for this exercise Allow your affected arm to hang straight down to the floor, keeping the shoulder muscles relaxed. Rotate your arm in a clockwise pattern ten times then counter-clockwise ten times and you should perform this exercise three times per day.

Rotation in codmans exercise

Forward and backward motion Perform 20 repetitions (a repetition is one cycle of the back-and-forth movement) three times per day.

Side-to-side motion Perform 20 repetition three times per day.

These exercise may be performed in a prone (face down) position or standing while leaning on a chair with the opposite arm.

Initially arm swing should begin at 15 degree angles and eventually progress to degree angles as pain subside within time.

Rehabilitation after arthroscopic Bankart repair It is paramount to protect healing tissue of anterior capsule during early stages of rehabilitation. Avoidance of terminal ABD/ER is crucial during this period.

A sling immobilizer is applies after surgery. Physiotherapy is started 7-10 days post op. Active-assisted ROM is performed at 2-8 wks. Isometric strengthening is performed at 8-12 wks.

When sport is allowed? The athlete is allowed to return to pre-injury conditioning programs and weight training at 12 wks. At 6 months the athlete is allowed to participate in contact sports if full and functional ROM and normal muscle strength have gained.