Bankart Repair (Arthroscopic or Open)

Days 1–7

Exercises

• Sling x 6 weeks – Even while sleeping
  • Place pillow under shoulder / arm while sleeping for comfort
• Hand squeezing exercises
• Elbow and wrist active motion (AROM) with shoulder in neutral position at side
• Supported pendulum exercises
• Shoulder shrugs / scapular retraction without resistance
• Ice pack

Goals

• Pain control
• Protection

Days 7–14

Exercises

• Continue sling x 6 weeks
• Continue appropriate previous exercises
• Active assisted motion (AAROM) supine with wand
  • Flexion and Abduction to 90 degrees
  • ER to within 50% of opposite shoulder
• AROM – IR (supine, abd to 45 degrees) to within 30 degrees of opp shoulder
• 1–2 Finger Isometrics x 6 (fist in box)
  • No Active Internal Rotation if Open Bankart
• Resisted elbow / wrist exercises (light dumbbell)
• Stationary bike (must wear sling)

Goals

• AAROM Flexion and Abduction to 90 degrees

Weeks 2–4

Exercises

• Continue sling x 6 weeks
• Continue appropriate previous exercises
• AAROM supine with wand
  • Flexion to 120 degrees
  • Abduction to 110 degrees
  • ER to within 80% of opposite shoulder
• AROM – IR (supine, abd to 60 degrees) to tolerance

Goals

• AAROM Flexion to 120 degrees, Abduction to 110 degrees

Weeks 4–6

Exercises

• Continue sling x 6 weeks
• Continue appropriate previous exercises
• Full pendulum exercises
• AAROM – Flexion (supine wand, pulleys) >120 degrees as tolerated
  • Abduction (supine wand, pulleys) to 120 degrees
  • ER (supine or standing wand) to within 15 degrees of opp shoulder
  • IR as tolerated (wand behind back) – Not if Open Bankart
• Push-up plus against wall – No elbow flexion > 90 degrees
• Prone scapular retraction exercises (without weights)
• Treadmill – Walking progression program

Goals

• AAROM Flexion >120 degrees, Abduction to 120 degrees

Weeks 6–9

Exercises

• D/C sling
• Continue appropriate previous exercises
• AAROM (pulleys, wall climbs, doorway stretches) through full range
• AROM through full range as tolerated
• Rotator cuff strengthening with light Theraband
  • ER and IR with arm at side and pillow or towel roll under arm
  • Flexion to 60 degrees
  • Abduction to 60 degrees
  • Scaption to 60 degrees
  • Extension to 30 degrees
• Standing rows with Theraband
• Prone scapular retraction exercises (with light weight)
• Ball on wall (arcs, alphabet)
• BAPS on hands
• Push-up progression – Wall to table (no elbow flexion > 90 degrees)
• Body Blade
• UBE forwards and backwards at low resistance
• Elliptical trainer
• Stairmaster
• Pool walking / running – No UE resistive exercises

Goals

• Full AROM
• 30 wall push-ups

Weeks 9–12

Exercises

• Continue appropriate previous exercises with increased resistance as tolerated
• PROM / mobilization as needed to regain full ROM
• Push-up progression – Table to chair (no elbow flexion > 90 degrees)
• Ball toss with arm at side using light ball
• Treadmill – Running progression program
• Pool walking / running – With UE resistance (no swimming)

Goals

• Normal rotator cuff strength

Months 3–4

Exercises

• Continue appropriate previous exercises
• Fitter on hands
• Ball toss overhead
• Push-ups, regular – No elbow flexion > 90 degrees
• Weight training with light resistance
  • No overhead press or pull downs behind head
  • No elbow flexion > 90 degrees with bench, dips, etc.
• Pool therapy

Goals

• Run 2 miles at easy pace
• 30 regular push-ups

Months 4–6

Exercises

• Continue appropriate previous exercises
• Push-ups – no elbow flexion > 90 degrees
• Sit-ups
• Swimming
• Running progression to track
• Progressive weight training
  • No elbow flexion > 90 degrees with bench, dips, etc.
• Transition to home / gym program

Goals

• Resume all activities
• Pass a return-to-sport / fitness test at 6 months post-op
• No contact sports until 6 months post-op

Home exercise sheet · shoulder phase 1

Perform exercises below frequently: 30 reps 3–5x a day

• Grip Squeeze
• Elbow active range of motion
• Pendulum
• Shoulder Shrugs
• Ice x 10–15 min 2–3 x per day

Abbreviations

AROM / AAROM / PROM: active / active-assisted / passive range of motion. ROM: range of motion. ER / IR: external / internal rotation. ABD / ADD: abduction / adduction. FLEX / EXT: flexion / extension. WBAT / PWB / TTWB / NWB: weight bearing as tolerated / partial / toe-touch / non-weight bearing. SLR: straight leg raise. HS: hamstrings. ITB: iliotibial band. UE / LE: upper / lower extremity. UBE: upper body ergometer (arm bike). BAPS: balance board. BFR: blood flow restriction training. PREs: progressive resistance exercises. D/C: discontinue. prn: as needed. POD: post-operative day. TENS: transcutaneous electrical nerve stimulation. ADLs: activities of daily living.

Source

Adapted from William Beaumont Army Medical Center, Physical Therapy Section, "Bankart WB08", Revised August 2008, published by William Beaumont Army Medical Center (a work of the U.S. Government in the public domain). Original: Bankart WB08.pdf. Army-specific wording in the original (APFT) was replaced with civilian equivalents.

This protocol is general guidance for the rehabilitation team and does not replace the specific plan, restrictions and follow-up we set together. Your own situation may differ: if anything here does not match what we talked about, what we talked about wins, so please ask me.

Current version and every other protocol: aaronweymd.com/post-op-protocols