PHYSICAL THERAPY PROTOCOL

Bankart Repair
Physical Therapy Protocol

Rehabilitation following arthroscopic Bankart repair is designed to protect the repaired labrum while gradually restoring shoulder motion, strength, dynamic stability, and confidence. Progression should respect soft tissue healing while minimizing postoperative stiffness.

0–6 Weeks

Protect Repair

6–12 Weeks

Restore Motion

12–20 Weeks

Strengthening

Goal

Stable Shoulder

Important Note

This protocol is intended as a general rehabilitation guideline. Patients with significant bone loss, remplissage, posterior labral repair, multidirectional instability, revision surgery, or associated procedures may require modifications. The surgeon's postoperative instructions always take precedence.

Rehabilitation Philosophy

The repaired labrum requires time to heal securely back to the glenoid. Early rehabilitation protects the repair while preventing stiffness. Strength and dynamic stability are restored gradually before returning to contact sports or overhead athletics.

Phase I: Protection Phase

Timeframe: 0–6 Weeks

Goals

  • Protect the labral repair
  • Control pain and swelling
  • Prevent postoperative stiffness
  • Maintain elbow, wrist, and hand motion
  • Begin protected passive motion

Sling

  • Sling full time except hygiene and exercises
  • Sleep in sling
  • No lifting
  • No supporting body weight
  • Avoid positions stressing the anterior capsule

Exercises

  • Pendulums
  • Passive forward elevation
  • Protected passive external rotation per surgeon guidelines
  • Elbow, wrist, and hand motion
  • Grip strengthening
  • Scapular retraction exercises

Avoid

  • Abduction with external rotation
  • Forceful external rotation
  • Active throwing motions
  • Pushing up from a chair
  • Heavy lifting

Phase II: Motion Phase

Timeframe: 6–12 Weeks

Goals

  • Restore full passive motion
  • Begin active-assisted and active motion
  • Normalize scapular mechanics
  • Gradually discontinue sling

Exercises

  • Cane exercises
  • Table slides
  • Wall walks
  • Pulleys
  • Scapular stabilization
  • Gentle posterior capsule stretching

Phase III: Strengthening Phase

Timeframe: 12–20 Weeks

Goals

  • Restore rotator cuff strength
  • Improve dynamic stability
  • Improve endurance
  • Restore normal shoulder mechanics

Exercises

  • Theraband strengthening
  • Rotator cuff strengthening
  • Scapular strengthening
  • Closed-chain stabilization
  • Proprioception training
  • Progressive dumbbell strengthening

Phase IV: Return To Sport

Timeframe: 20–24+ Weeks

Strength

Restore symmetric shoulder strength and endurance.

Function

Progress sport-specific drills and work-specific activities.

Stability

Ensure excellent dynamic shoulder control before unrestricted activity.

Return To Activity Guidelines

Desk Work

Usually 1–2 weeks.

Driving

After sling discontinuation and when safe vehicle control has returned.

Daily Activities

Gradually increase after 6 weeks.

Weight Training

Usually begins around 3 months with gradual progression.

Throwing Program

Typically begins around 5–6 months for appropriate athletes.

Contact Sports

Usually 6 months after surgery once strength, stability, and function have returned.

Therapist Notes

  • Protect the anterior labral repair during the first 6 weeks.
  • Avoid excessive external rotation early.
  • Progress range of motion gradually.
  • Emphasize rotator cuff and scapular strengthening.
  • Dynamic stabilization is essential before return to athletics.
  • Notify the office if instability symptoms recur.

Red Flags

Contact The Office For

  • Increasing pain
  • Redness or drainage
  • Recurrent instability
  • Sudden loss of motion
  • Loss of shoulder function

Seek Urgent Care For

  • Chest pain
  • Shortness of breath
  • Calf pain or swelling
  • Severe uncontrolled pain

Related Resources

Questions About Bankart Repair Rehabilitation?

Successful rehabilitation protects the healing labrum while restoring strength and dynamic shoulder stability, allowing a safe return to work, sports, and everyday activities.

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