| Phase | Timeline | Goals & Interventions | Avoid |
|---|---|---|---|
| Phase 1: Protection & Early Mobility | 0–2 weeks | – Sling (except hygiene) – Pendulums – Hand/elbow/wrist ROM – Patient education |
– ER stretching – ABD/ER combo – Resisted elbow flexion |
| Phase 2: Passive & Assisted Motion | 2–4 weeks | – Wean sling gradually – Passive flexion <120° – ER to neutral (handshake) – Begin scapular setting – Short lever AAROM |
– ER past neutral – ABD/ER in 90/90 |
| Phase 3: Active Motion & Control | 4–6 weeks | – Light activity only (e.g., cup of tea test) – Progress to full AROM in safe planes – Begin low-intensity isometrics |
– Forceful ER or IR – Overhead carrying/lifting |
| Phase 4: Strength & Control Development | 6–12 weeks | – Begin CKC & proprioceptive drills – Initiate cuff and deltoid strengthening – ER to 45–60° if stable – Avoid over-prioritizing full ROM |
– Overhead or resisted ER – Biceps curls or heavy carrying |
| Phase 5: Sport-Specific Prep | 12–20 weeks | – Introduce overhead/return-to-throwing if applicable – Increase load under dynamic control – Ensure scapular rhythm and strength ≥90% |
– Return to contact without clearance |
| Phase 6: Return to Sport/Work | 20+ weeks | – Clearance if: stable, pain-free, no apprehension – Strength and ROM sufficient for role demands – Sport-specific reconditioning |
– Repeated ER loading beyond functional range |
No signs of subluxation during testing (e.g., load-and-shift)
