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Rehab to Return: Shoulder and Elbow Injury Protocols
A precise, phased rehab approach restores arm health and performance after shoulder or elbow injuries. These evidence-based sequences guide you from early mobilization to sport-specific strengthening, helping athletes return stronger and more resilient.
Rehab Phase Overview
| Phase | Goals | Duration |
|---|---|---|
| I. Acute & Protection | Reduce pain/swelling; protect tissues | 1–2 weeks |
| II. Mobility & Control | Restore range of motion; neuromuscular control | 2–4 weeks |
| III. Strength & Endurance | Build foundational strength; endurance | 4–8 weeks |
| IV. Sport-Specific | Integrate throwing/hitting patterns | 8–12 weeks |
| V. Return to Play | Full workload progression; performance testing | 2–4 weeks |
Phase I: Acute & Protection
- Rest and cryotherapy: Ice 15–20 minutes, 2–3× daily.
- Compression sleeve or brace to limit harmful motion.
- Gentle isometrics for rotator cuff and forearm flexors: 3×10-second holds.
Phase II: Mobility & Control
| Exercise | Reps & Sets | Equipment |
|---|---|---|
| Passive Pendulum Swings | 3×20 swings | Table support |
| Prone T’s and Y’s | 3×12 each | No weight/light dumbbells |
| Scapular Retractions | 3×15 | Resistance band |
| Wrist Flexor Stretch | 3×30 seconds each | Wall or partner |
Focus on pain-free motion and proper scapulothoracic rhythm.
Phase III: Strength & Endurance
| Exercise | Reps & Sets | Equipment |
|---|---|---|
| External Rotation at 0° & 90° | 3×12 each | Resistance band |
| Dumbbell Lateral Raises (<5 lb) | 3×15 | Light dumbbells |
| Prone Rows (Scapular Focus) | 3×10 | Dumbbells |
| Wrist Extension & Flexion | 3×15 each | Light dumbbells |
Monitor fatigue; stop if form breaks down or pain returns.
Phase IV: Sport-Specific Integration
- Light Toss Progression: Start at 45 ft, 8 throws @ 50% effort; advance distance and effort weekly.
- Banded Throwing Mentors: Attach elastic behind you; simulate acceleration phase without ball release. 3×10 reps.
- Med-Ball Throws: Side throws and scoop patterns at low load (6–8 lb), 3×6 each side.
These drills refine neuromuscular patterns in throwing and hitting motions.
Phase V: Return to Play Testing
| Test | Success Criterion |
|---|---|
| Long Toss Distance | 90% of pre-injury distance |
| Velocity Comparison | Within 5% of baseline |
| Pain-Free Full Effort Bullpen | No pain or compensation |
| Functional Movement Screen | ≥16/21 score |
Pass all criteria before unrestricted practice. Continue maintenance exercises year-round to prevent reinjury.
Prevention and Maintenance
- Weekly rotator cuff circuit: External rot, internal rot, prone T’s.
- Dynamic warm-ups: Sleeper stretch, band pull-aparts, and thoracic rotations.
- Workload monitoring: Track throws, RPE, and soreness in an arm-care diary.
Key Takeaways
- Follow structured phases: Protection, Mobility, Strength, Sport-Specific, Testing.
- Prioritize pain-free progression—never advance if symptoms recur.
- Use banded drills and med-ball sequences to re-establish movement patterns.
- Validate readiness with objective tests before full return.
- Implement ongoing maintenance routines to safeguard arm health.
Ready to implement a reproducible, science-backed rehab plan and return stronger?
Learn more → https://nextswingbaseball.com/virtual-training