Latarjet Procedure

Physical Therapy Protocol

General Considerations

The Latarjet procedure addresses recurrent anterior shoulder instability by transferring the coracoid process to the anterior glenoid, providing a sling effect and bony support. Recovery is staged and based on tissue healing, joint mobility, and performance goals.

Timing of Progression May Vary Based On:

• Degree of instability or laxity
• Size and chronicity of injury
• Quality of soft tissue and bony integrity
• Duration of pre-op immobilization
• ROM/strength at surgery
• Activity or sport-specific demands

Immobilization Guidelines

• Sling: 3 weeks full-time, including sleep

Range of Motion Restrictions

• Initiate ER/IR: In scapular plane at 30° abduction
• Flexion/Abduction: Begin gentle progression at week 2
• External Rotation: Limit to 30° until week 4, then 45° until week 6
• Internal Rotation: Limit to 45° until week 6

Activity Restrictions

• No resisted exercises during early phase
• Avoid overhead and sport-specific movement until cleared
• Focus on pain-free ROM and muscle activation

Return to Activities

• Weight Training – 16 weeks
• Skiing – 16 weeks
• Golf – 8 weeks (chip & putt), 12 weeks (full swing)
• Tennis – 16 weeks
• Contact Sports – 5 months

Phase I – Protection & Early Motion (Weeks 1–3)

Goals:

• Protect surgical repair
• Minimize pain and inflammation
• Initiate passive motion within limits
• Begin gentle scapular and distal mobility

Weeks 1–2 (HEP only):

• Pendulums
• Elbow, wrist, hand AROM
• Scapular retraction, scapular clock (no resistance)

Week 3 (Initiate PT):

• Passive ROM within limits

Phase II – Controlled Range of Motion (Weeks 4–9)

Goals:

• Regain passive and active ROM
• Wean from sling
• Begin light muscle activation

Weeks 4–6:

• Discontinue sling
• Progress passive ROM within limits

Weeks 7–9:

• Progress to AA/AROM
• Submaximal, pain-free isometrics (all directions)
• Rhythmic stabilization drills
• Light scapular retraction and ER/IR strengthening

Phase III – Strengthening (Weeks 10–15)

Goals:

• Restore functional strength
• Normalize neuromuscular control
• Improve shoulder stability

Exercises:

• Rotator cuff: Abduction, Forward Flexion, Scaption, ER/IR at 0°
• Scapular: Rows, Forward Press, Horizontal Adduction/Abduction
• Terminal stretches for full ROM
• Proprioception (including closed chain)
• Push-up plus progression
• Low-intensity skill training (no overhead)

Phase IV – Functional Progression (4 Months +)

Goals:

• Return to full function and sport
• Emphasize eccentric and overhead control

Interventions:

• Initiate weight training
• Progress overhead motion tolerance
• Begin sport-specific and plyometric drills