Nathan WM. Skelley, M.D.

PHASE I - Acute Phase (week 1)

Goals:- Improve motion
- Diminish pain and inflammation - Retard muscle atrophy

Exercises:
1. Stretching for wrist and elbow joint, stretches for shoulder joint
2. Strengthening exercises isometrics for wrist elbow, and shoulder musculature 3. Pain and inflammation control: cryotherapy, ultrasound, and whirlpool

 

PHASE II - Subacute Phase (weeks 2-4)

Goals:- Normalize motion
- Improve muscular strength, power, and

endurance

Week 2

1. Initiate isotonic strengthening for wrist and elbow muscles
2. Continue use of cryotherapy, etc.
Week 3
1. Initiate rhythmic stabilization drills for elbow and shoulder joint 2. Progress isotonic strengthening for entire upper extremity

3. Initiate isokinetic strengthening exercises for elbow flexion/extension

Week 4

1. Initiate throwers' ten program
2. Emphasize eccentric biceps work, concentric triceps and wrist flexor work 3. Program endurance training
4. Initiate light plyometric drills
5. Initiate swinging drills

 

PHASE III - Subacute Phase (weeks 5-8)
Goals: - Preparation of athlete for return to functional activities

Criteria to Progress to Advanced Phase 1. Full non-painful ROM
2. No pain or tenderness
3. Satisfactory isokinetic test

4. Satisfactory clinical exam

Weeks 4-5

1. Continue strengthening exercises, endurance drills, and flexibility exercises daily 2. Thrower’s ten program
3. Progress plyometric drills

Continued

4. Emphasize maintenance program based on pathology 5. Progress swinging drills (i.e., hitting)

Weeks 6-8

1. Initiate interval sport program once determined by physician Phase I program

 

PHASE IV - Return to Activity Phase (weeks 6-9)

Weeks 6 through 9 - when you return to play depends on your condition and progress. Dr. Skelley will determine when it is safe. 1. Continue strengthening program thrower’s ten program
2. Continue flexibility program
3. Progress functional drills to unrestricted play