Arthroscopic Posterior Stabilisation

Indications:

Post op
Day 1 - 3 weeks Level 1 Exercises	External Rotation brace for 3 weeks (can remove for washing and exercise; wear on outside of clothes). Teach axillary hygiene Teach postural awareness and scapular setting Active assisted ROM as comfortable (use 'safe zone' as guide) Core stabiliity exercises with sling (as appropriate) No combined forward flexion and Internal rotation exercises Do not force or stretch
3 -6 Weeks Level 2-3 Exercises	Wean off sling Progress Active assisted to Active ROM as comfortable Commence proprioceptive exercises (minimal weightbearing below 90 degrees) No combined forward flexion and Internal rotation exercises Do not force or stretch
6 - 12 Weeks Progress to Level 3+ Exercises	The sling is removed by 6 weeks Regain scapula & glenohumeral stability working for shoulder joint control rather than range Gradually increase ROM Strengthen - sports specific Increase proprioception through open & closed chain exercise Progress core stability exercises Incorporate plyometrics and pertubation training After 2 months any residual tightness to internal rotation may be addressed by specific stretching exercises

Milestones
Week 6	Active elevation to pre op level
Week 12	Minimum 80% range of internal rotation compared to asymptomatic side Normal movement patterns throughout range
Failure to achieve milestones	Referral to shoulder clinic

Return to functional activities (guide to commence activity)
Return to work	Sedentary job: as tolerated Manual job: at least 3 months
Driving	approx. 6-8 weeks
Swimming	Breaststroke: from 6 weeks Freestyle: 12 weeks
Golf	can start from 3-6 Months
Lifting	Light lifting can begin at 3 weeks. Avoid lifting heavy items for 3 months.
Contact Sport	E.g. Horse riding, football, martial arts, racket sports and rock climbing: after 3 months