Bankart repair for unstable dislocating shoulders: Surgery to anatomically and securely repair the torn anterior glenoid labrum and capsule without arthroscopy can lessen pain and improve function for active individuals.

Edited By: Frederick A. Matsen III, M.D., Winston J. Warme, MD
Last updated Tuesday, November 13, 2007

Figure 12 - Example of shoulder exercise

Figure 13 - Examples of shoulder exercises

Rehabilitation

What types of physical therapy do patients require after surgical repair for shoulder dislocations for shoulder dislocations?

A progressive rehabilitation program after instability surgery is critical for achieving optimal shoulder function.

Instable shoulders may become stiff after surgery, so early protected motion is often suggested. However, the repair needs to be protected from re-injury, especially during the healing period. Thus, the surgeon will often prescribe limited early motion for three to six weeks and then strengthening exercises for a second six-week period.

What options exist for rehabilitation after surgical repair for shoulder dislocations for shoulder dislocations?

It is often most effective for patients to carry out their own exercises so that they are done frequently, effectively and comfortably. Usually, a physical therapist or the surgeon instructs the patient in the exercise program and advances it at a rate that is comfortable for the patient.

For the first six weeks after surgery, emphasis is placed on protected motion. For the second six weeks, emphasis is placed on strengthening exercises to so that strong muscles will protect the shoulder as it returns to normal activities.

The figures show examples of some of the exercises that may be used to develop strength and flexibility after the first six weeks following surgery; however, the surgeon must be consulted for the specifics on each case.

Once the range of motion and strength goals are achieved, the exercise program can be cut back to a minimal level. However, gentle stretching is recommended on an ongoing basis.

Patients are almost always satisfied with the increases in range of motion, comfort, and function that they achieve with the exercise program. If the exercises are uncomfortable, difficult or painful, the patient should contact the surgeon promptly.

Stressful activities and activities with the arm in extreme positions must be avoided until healing is almost complete--often for three months after the surgery.

In general the exercises are best performed by the patient at home. Occasional visits to the surgeon or therapist may be useful to check the progress and to review the program.

The surgeon and therapist should be able to provide the information on the usual cost of the rehabilitation program. The program is quite cost-effective, because it is heavily based on home exercises.

This is a safe rehabilitation program with little risk.

How long after surgical repair for shoulder dislocations for shoulder dislocations will patients be able to return to ordinary daily activities?

In general, patients are able to perform gentle activities of daily living with the operated arm at the side starting two to three weeks after surgery. Walking with the arm protected is strongly encouraged. Driving should wait until the patient can perform the necessary functions comfortably and confidently. This may take up to one month if the surgery has been performed on the right shoulder, because of the increased demands on the right shoulder for shifting gears.

With the consent of their surgeon, patients can often return to activities such as swimming, golf and tennis at six weeks after their surgery.

Patients should avoid activities that involve major impact (chopping wood, contact sports, sports with major risk of falls) or heavy loads (lifting of heavy weights, heavy resistance exercises) until three months after surgery., and until the shoulder has excellent strength and range of motion--essentially equivalent to the opposite side. In this way the risk of re-injury is minimized.

Surgery for shoulder dislocations at the University of Washington

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