Latissimus Tendon Repair
Latissimus / Teres Major Repair
Phase I (Weeks 0-2): Protect Repair
- Sling to be worn at all times for 6 weeks except for showering and rehab exercises
- Patient to do Home Exercises given post-op (pendulums, elbow ROM, wrist ROM, grip strengthening)
Phase II (Weeks 2-6): Protect Repair/ROM
- True PROM only! The tendon needs to heal back into the bone.
- ROM goals: 90° FF/30° ER at side; ABD max 40-60 without rotation
- No resisted motions of shoulder until 12 weeks post-op
- Grip strengthening
- No canes/pulleys until 6 weeks post-op, because these are active-assist exercises
- Heat before PT, ice after PT
Phase III (Weeks 6-12): Advance ROM
- Begin AAROM > AROM as tolerated
- Goals: Same as above, but can increase as tolerated
- Light passive stretching at end ranges
- Begin scapular exercises, PRE for large muscle groups (pecs, lats, etc.)
- Isometrics with arm at side beginning at 8 weeks
Phase IV (Months 3-12): Restore Function/Return to Sports
- Advance to full ROM as tolerated with passive stretching at end ranges
- Advance strengthening as tolerated: isometrics > bands > light weights (1-5 lbs); 8-12 reps/2-3 sets per rotator cuff, deltoid, and scapular stabilizers
- Only do strengthening 3x/week to avoid rotator cuff tendonitis
- Begin eccentrically resisted motions, plyo (ex. Weighted ball toss), proprioception (es. body blade)
- Begin sports related rehab at 4 months, including advanced conditioning
- Return to throwing at 4 months, begin with light toss
- Return to throwing from the pitcher’s mound at 6 months
- Return to full competition 9-12 months
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