Work and Activity Restrictions
• Sling immobilization until discomfort resolves
• May return to work or sport once full, painless active range of motion (ROM) and strength return
• No external rotation past 90 degrees or “90/90 positions” for 6 weeks
Phase I (0–2 Weeks): Reduction of Inflammation
• Elbow, wrist, and hand exercises immediately
• Sling immobilization until discomfort from the initial event resolves (usually less than 1 week)
• NSAIDs as needed
• After deltoid activation, begin pendulums with 3–4 sets of 30 repetitions each
• Scapular retraction exercises
Phase II (2–6 Weeks): Range of Motion
• Discontinue sling if not already done
• Begin formal physical therapy – deltoid and rotator cuff isometric exercises, proprioceptive work
• Monitor JPL exercises and return of ROM
• Perform JPL Exercises Phases I and II
Phase III (6 Weeks+): Strengthening and Proprioception
• Begin JPL Exercises Phase III
• May begin abduction and external rotation positions up to 90 degrees
Note: “90/90 position” refers to 90 degrees of abduction and 90 degrees of external rotation — the position of apprehension.
