| Phase | Timeline | Goals & Interventions | Avoid |
|---|---|---|---|
| Phase 1: Early Mobility & Control | 0–2 weeks | – Discontinue sling as tolerated – AROM + AAROM – Table/wall slides – Scapular setting – Isometric RC – CKC (e.g., weight shifts on wall) |
– Heavy lifting – Sustained overhead activity |
| Phase 2: Recruitment & Functional ROM | 2–4 weeks | – Full active ROM expected – Proprioception drills – Light scapular retraction + RC control – Introduce therabands – Light closed chain loading |
– Poor form/compensations – End-range overload |
| Phase 3: Strengthening Phase | 4–6 weeks | – Functional strength (deltoid, cuff, scapular) – Dynamic scapular drills – Begin endurance (light loads, high reps) – CKC and open chain mix |
– Overhead resistance if control poor |
| Phase 4: Return to Activity/Work | 6–12 weeks | – Restore strength and control through range – Gradual return to lifting – Full functional patterns (push/pull) |
– Rapid return to heavy overhead work |
| Phase 5: Performance Integration | 12+ weeks | – Overhead power, sports, and endurance – Only progress if neuromuscular control is consistent – May include high-level plyometrics or loaded overhead drills |
– Repetitive overhead fatigue without tolerance |
