Procedures II Exam II

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  1. Surgerical intervention criteria
    • Bankart lesion:
    • athlete <20 wanting to continue sports
    • bony trauma
  2. Components of GH stability
    • jt cohesion/negative pressure
    • bony jt conformity
    • glenoid labrum
    • dynamic stabilizers: RTC, biceps, scapular mm
    • static stabilizers: capsular and ligament restraints
  3. Bankart Rehab Phase I
    • Goals: weeks 0-3
    • educate athlete
    • start mm contractions
    • decrease edema and pain
    • protect surgical site
    • maintain proximal and distal strength
  4. Bankart Phase I exercises
    • Week 1: wear sling at all times except therapy~
    • PROM and AAROM allowed: flex to 90 or 110 as long as not R2; ER in scapular plane 40 and IR 60
    • Pendulum exercises, wall/door pulleys
    • AROM and isometrics for elbow, wrist and hand
    • Scap setting
    • Day 7 can do suping IR/ER rhythmic stabilization at 45 of abd
    • SA strengthening below 90
  5. Bankart Phase I precautions
    • avoid shrug with scap setting and pulleys
    • no active ER, abd, or ext.
    • shoulder pain needs to dissipate prior to next set
    • no GH mobs in anterior direction
    • avoid flex and stress to IGHLC
  6. Bankart Phase II Goals: weels 3-6
    • D/C sling with MD permission
    • protect surgical site
    • neuromuscular re-ed of ER ans scapulothoracic mm
    • critical healing time is 0-6 weeks
    • athlete can't drive w/out MD approval
  7. Bankart Phase II exercises
    • sub max isometrics for ER and abd.
    • pendulums
    • scap setting
    • rone horizontal abd ext 100
    • sideling ER, standing IR/ER thera band
    • SA in supine and prone-- closed chain not the best
  8. Bankart Phase II precautions
    • post. capsular tightness can lead to GH superior anterior translation
    • weakness of SA presents as increased downward rotation of scap
    • avoid resistance to IR until week 6
    • avoid prone horizontal abd
  9. Bankart Phase III Goals
    • flex to 11; abd to 110; ER in scapular plane to 40; IR in scapular plane to 60
    • no pain with progressive resistance
    • normalization of posterior shoulder flexibility
    • no should shrug with flexion
  10. Bankart Phase III exercises
    • start IR with light resistance weekd 6
    • PNF coupled motions
    • GH abd
    • IR/ER at 90 abd
    • plyos at week 14
    • throwing and batting at 4 mo.
  11. Bankart Return to Play Criteria
    • pain free full ROM
    • normalized strength
    • progressed through throwing or hitting program
    • demonstrates good tecnique
    • total arc of motion is 180
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Procedures II Exam II
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