Skip to main content
NCBI home page
Journal of Athletic Training logoLink to Journal of Athletic Training
. 2000 Jul-Sep;35(3):373–381.

Rehabilitation after Ligamentous and Labral Surgery of the Shoulder: Guiding Concepts

Turner A Blackburn Jr 1, John A Guido Jr 1
PMCID: PMC1323399  PMID: 16558650

Abstract

Objective:

To provide treatment guidelines for rehabilitation after ligamentous and labral surgery of the shoulder.

Data Sources:

We searched Index Medicus for the last 10 years using the key words “shoulder instability,” “shoulder exercises,” and “shoulder surgery.”

Data Synthesis:

Detailed rehabilitation programs for patients with anterior shoulder instability reconstructions can be found in the literature, but many are based on anecdotal evidence and clinical observation. Randomized, prospective outcome studies on these rehabilitation protocols have not been performed. Therefore, we offer a performance- and criteria-based guideline for rehabilitation that is rooted in basic science, surgeons' recommendations, clinical experience, and common sense.

Conclusions/Recommendations:

To return an athlete to the preinjury level of function, range of motion, strengthening, proprioception, and functional activities must be used judiciously, keeping healing constraints and arthrokinematics in mind.

Keywords: anterior instability, capsulorrhaphy, glenoid labrum

Full text

PDF
373

Images in this article

376Figure 1.
on p.376
376Figure 2.
on p.376
376Figure 3.
on p.376
376Figure 4.
on p.376
377Figure 5.
on p.377
377Figure 6.
on p.377
377Figure 7.
on p.377
377Figure 8.
on p.377
378Figure 9.
on p.378
378Figure 10.
on p.378
378Figure 11.
on p.378
378Figure 12.
on p.378

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bowen M. K., Warren R. F. Ligamentous control of shoulder stability based on selective cutting and static translation experiments. Clin Sports Med. 1991 Oct;10(4):757–782. [PubMed] [Google Scholar]
  2. Ellenbecker T. S., Mattalino A. J. Glenohumeral joint range of motion and rotator cuff strength following arthroscopic anterior stabilization with thermal capsulorraphy. J Orthop Sports Phys Ther. 1999 Mar;29(3):160–167. doi: 10.2519/jospt.1999.29.3.160. [DOI] [PubMed] [Google Scholar]
  3. Green M. R., Christensen K. P. Arthroscopic versus open Bankart procedures: a comparison of early morbidity and complications. Arthroscopy. 1993;9(4):371–374. doi: 10.1016/s0749-8063(05)80308-1. [DOI] [PubMed] [Google Scholar]
  4. Guanche C. A., Quick D. C., Sodergren K. M., Buss D. D. Arthroscopic versus open reconstruction of the shoulder in patients with isolated Bankart lesions. Am J Sports Med. 1996 Mar-Apr;24(2):144–148. doi: 10.1177/036354659602400204. [DOI] [PubMed] [Google Scholar]
  5. Hayashi K., Massa K. L., Thabit G., 3rd, Fanton G. S., Dillingham M. F., Gilchrist K. W., Markel M. D. Histologic evaluation of the glenohumeral joint capsule after the laser-assisted capsular shift procedure for glenohumeral instability. Am J Sports Med. 1999 Mar-Apr;27(2):162–167. doi: 10.1177/03635465990270020801. [DOI] [PubMed] [Google Scholar]
  6. Jobe F. W., Giangarra C. E., Kvitne R. S., Glousman R. E. Anterior capsulolabral reconstruction of the shoulder in athletes in overhand sports. Am J Sports Med. 1991 Sep-Oct;19(5):428–434. doi: 10.1177/036354659101900502. [DOI] [PubMed] [Google Scholar]
  7. Moseley J. B., Jr, Jobe F. W., Pink M., Perry J., Tibone J. EMG analysis of the scapular muscles during a shoulder rehabilitation program. Am J Sports Med. 1992 Mar-Apr;20(2):128–134. doi: 10.1177/036354659202000206. [DOI] [PubMed] [Google Scholar]
  8. Naseef G. S., 3rd, Foster T. E., Trauner K., Solhpour S., Anderson R. R., Zarins B. The thermal properties of bovine joint capsule. The basic science of laser- and radiofrequency-induced capsular shrinkage. Am J Sports Med. 1997 Sep-Oct;25(5):670–674. doi: 10.1177/036354659702500514. [DOI] [PubMed] [Google Scholar]
  9. O'Brien S. J., Neves M. C., Arnoczky S. P., Rozbruck S. R., Dicarlo E. F., Warren R. F., Schwartz R., Wickiewicz T. L. The anatomy and histology of the inferior glenohumeral ligament complex of the shoulder. Am J Sports Med. 1990 Sep-Oct;18(5):449–456. doi: 10.1177/036354659001800501. [DOI] [PubMed] [Google Scholar]
  10. Paine R. M., Voight M. The role of the scapula. J Orthop Sports Phys Ther. 1993 Jul;18(1):386–391. doi: 10.2519/jospt.1993.18.1.386. [DOI] [PubMed] [Google Scholar]
  11. Schaefer S. L., Ciarelli M. J., Arnoczky S. P., Ross H. E. Tissue shrinkage with the holmium:yttrium aluminum garnet laser. A postoperative assessment of tissue length, stiffness, and structure. Am J Sports Med. 1997 Nov-Dec;25(6):841–848. doi: 10.1177/036354659702500619. [DOI] [PubMed] [Google Scholar]
  12. Selecky M. T., Vangsness C. T., Jr, Liao W. L., Saadat V., Hedman T. P. The effects of laser-induced collagen shortening on the biomechanical properties of the inferior glenohumeral ligament complex. Am J Sports Med. 1999 Mar-Apr;27(2):168–172. doi: 10.1177/03635465990270020901. [DOI] [PubMed] [Google Scholar]
  13. Snyder S. J., Karzel R. P., Del Pizzo W., Ferkel R. D., Friedman M. J. SLAP lesions of the shoulder. Arthroscopy. 1990;6(4):274–279. doi: 10.1016/0749-8063(90)90056-j. [DOI] [PubMed] [Google Scholar]
  14. Townsend H., Jobe F. W., Pink M., Perry J. Electromyographic analysis of the glenohumeral muscles during a baseball rehabilitation program. Am J Sports Med. 1991 May-Jun;19(3):264–272. doi: 10.1177/036354659101900309. [DOI] [PubMed] [Google Scholar]
  15. Turkel S. J., Panio M. W., Marshall J. L., Girgis F. G. Stabilizing mechanisms preventing anterior dislocation of the glenohumeral joint. J Bone Joint Surg Am. 1981 Oct;63(8):1208–1217. [PubMed] [Google Scholar]
  16. Wilk K. E., Arrigo C. Current concepts in the rehabilitation of the athletic shoulder. J Orthop Sports Phys Ther. 1993 Jul;18(1):365–378. doi: 10.2519/jospt.1993.18.1.365. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Athletic Training are provided here courtesy of National Athletic Trainers Association

RESOURCES