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Phase 1 (0-2 weeks)

• Sling immobilization at all times; hand, wrist, elbow exercises started

Phase 2 (2-3 weeks)

• Codman exercises, PROM 0-90 degrees flexion and abduction; external rotation in adduction to neutral; avoid extension of arm behind body for 4 weeks
• No external rotation in abduction because of peel-back mechanism
• Sling immobilization when not doing PROM regimen

Phase 3 (3-6 weeks)

• Discontinue sling and start progressive PROM to full as tolerated in all planes
• Begin passive posterior capsular and internal rotation stretching
• Begin passive and manual scapulothoracic mobility program
• Begin external rotation in abduction
• Allow use of operative extremity for light activities of daily living

Phase 4 (6-16 weeks)

• Continue all stretching and flexibility programs as above; ROM should be full
• Begin progressive strengthening of rotator cuff, scapular stabilizers, and deltoid
• At 10-12 weeks, biceps resistance and sports/work specific exercises instituted with goal of normal function at 4 months

For Throwing Athlete:Phase 5 (4-6 months)

• Begin interval throwing program on level surface (if applicable)
• Continue stretching and strengthening regimen, with particular emphasis on posterior capsular stretching

Phase 6 (6 months)

• Begin throwing from mound

Phase 7 (7 months)

• Allow full-velocity throwing from mound
• Continue strengthening and posterior capsular stretching indefinitely