Rehab Protocol: Posterior Bankart Repair

First 4 weeks

Keep your arm in the sling, but open the sling a few times per day to allow the elbow to straighten. You need to sleep with the sling on as well. Apply ice packs to the shoulder during the first few days for 15-20 minutes at a time. Hand and wrist exercises should be done with the arm in the sling. The sling can be carefully removed when changing clothes or going for a shower, but keep the operated shoulder completely relaxed. Do not lean on the affected arm to push yourself up from a bed or chair. To wash under your arm, bend forward while keeping your arm and shoulder relaxed. Gravity will cause your arm to go away from your body, allowing easy access to your armpit. Keep your dressings on until the first postoperative visit at 2 weeks. The dressings are waterproof, but try to keep them as dry as possible. If they become very soiled or soaked, they should be replaced. It is normal to develop bruising on the shoulder after surgery. Please call Dr Grey urgently if any redness appears around the dressings or if your pain suddenly worsens.

4 – 6 weeks

You will be referred to a physiotherapist after 4 weeks. Start with gentle pendulum exercises, allowing the arm to hang free while leaning forward. Gentle, active-assisted shoulder movements (using your opposite arm to move the operated shoulder) can be performed after 4 weeks. Do not force or stretch anything. Small active shoulder movements (without supporting the arm) can be performed as tolerated, but without resistance. Limit forward elevation to shoulder level (90 degrees) and avoid combined forward flexion, shoulder adduction (moving the arm across your chest) and internal rotation. The sling can be weaned gradually after 4-6 weeks.

6 – 12 weeks

Continue active-assisted movements and progress to full active range-of-motion exercises (Aim for full range of motion by 12–16 weeks). Gradual strengthening is initiated after 10 weeks, but avoid heavy lifting and placing high loads on the shoulder. The physiotherapist will also work on scapular posture and proprioception exercises. You can start driving at about 6 – 8 weeks.

After 12 weeks

The physiotherapist will focus on strength and endurance training. Sport-specific exercises are commenced once the full range of shoulder motion has been achieved. Depending on the type of sports, full participation will only be safe between 3 and 6 months. Manual labourers should only return to normal duty at about 3 – 4 months.