Superior Capsular Reconstruction

Rehab Protocol

For the first two weeks, wear the brace at all times and avoid any movement of the shoulder.
Avoid any weight lifting for at least the first 12 weeks.
Avoid any excessive motion of the surgical arm in all planes for the first 4 weeks.

Phase	Brace	ROM	WB	Exercises
Weeks 0-4	Weeks 0-2: Wear at all times*; Weeks 2-6: Worn daytime only	Weeks 0-2: No ROM; Weeks 2-4: PROM; limit: Flex 90°, Ext 20°, ER 45°, Abd 45°, ABER 45°	NWB	Weeks 0-2: Elbow/wrist ROM, grip strength/pendulums; Weeks 2-6: PROM to ER to 45°; Codman's, posterior cap mobilizations; closed chain scapular ex
Weeks 6-12	None	Begin A/AAROM; Advance to Flex 140°, Abd 135°, ABER 90°, ABIR 45°**	NWB	Begin active-assisted ex, deltoid/RTC isometrics at 8 weeks; begin resistive ex for scap stabilizers, bi/triceps, and RTC***
Weeks 12-16	None	Progress to full AROM	PWB	Begin ER and lat eccentrics, GH stabilization; muscle endurance activities; cycling/running as tolerated at 12 weeks.
Months 4-6	None	FAROM	PWB	Progress scap stabilization and eccentric strengthening; scap perturbation; begin plyo and throwing/racquet program; maintain ROM/flexibility
Months 6-8	None	FAROM	WBAT	Progress Phase IV activities, return to full activity as tolerated

*Off for hygiene and gentle home exercise

**if a distal clavicle excision is performed, horizontal adduction is restricted for 8 weeks post-op

***if a biceps tenodesis is performed, avoid active flexion of biceps and eccentric loads on biceps for 6 weeks post-op