Adam Seidl, MD - Board Certified Orthopaedic Surgeon - Shoulder and Elbow Specialist

Adam Seidl, MDBoard Certified Orthopaedic SurgeonShoulder and Elbow Specialist

Latissimus Transfer (Subscap)

PHASE I: Protected ROM (8 weeks)

  • May remove dressing and shower postop day # 3.
  • Sutures are all underneath the skin and will dissolve on their own.
  • Ice or cold flow systems encouraged for the first week at a minimum: should be used 3-4 times per day.
  • Sling should be in place when not performing exercises.
  • Hold pendulum exercises until 4 weeks following surgery
  • May start active scapular mobility exercises at 6 weeks – Must keep the shoulder musculature relaxed.
  • Avoid all active and active assistive exercises until cleared by the surgeon. This includes pulley exercises, wand and supine assisted exercises.
  • Initiate exercise program 3 times per day:
    • Immediate elbow, forearm and hand range of motion out of sling
    • Passive external rotation of the shoulder to 30 - instruct family member (start at 6 weeks)
    • PROM into scapular plane elevation to 120 degrees (start at 6 weeks)

PHASE II: Progressive ROM (8 to 12 weeks)

  • May discontinue sling.
  • Lifting restriction of 5 pounds should be reinforced with patient.
  • Start AAROM and AROM – includes pulleys, wand and supine gravity assisted exercises. Emphasize all motions except IR behind the back until 3 months.
  • Isolate and strengthen scapular stabilizers.
  • Progress PROM and capsular stretching of the shoulder as needed – elevation and external rotation as tolerated
  • Avoid resisted training or strengthening. Avoid AROM in positions of subacromial impingement.

PHASE III: ( >12 weeks)

  • Discontinue formal lifting restrictions.
  • Start progressive rotator cuff and shoulder strengthening at 3 months – isometrics initially
  • Initiate isotonic strengthening at 4 months (Theraband, dumbbells, Hughston’s exercises, etc). Include home cuff strengthening program. Continue to emphasize scapular stabilizers.
  • Equate active and passive range of motion. Encourage scapulohumeral mechanics during active shoulder motion.
  • Simulate work/recreational activities as rotator cuff strength and endurance improve.

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Location Map

  • Orthopedics - University of Colorado Hospital

    1635 Aurora Ct,4th Floor
    Aurora, CO 80045

  • Highlands Ranch Hospital

    1500 Park Central Dr #401,
    Highlands Ranch,CO 80129

  • UCHealth Steadman Hawkins Clinic Denver

    175 Inverness Drive West, Suite 200,
    Englewood, CO 80112

Credibility Logos

  • The American Board of Orthopaedic Surgery logo
  • American Academy of Orthopedic Surgeons logo
  • American Shoulder And Elbow Surgeons logo
  • Western Orthopaedic Association logo
  • Alpha Omega Alpha
  • Moon Shoulder