Phase 4: Return to Throwing Phase 4 of the rehabilitation program encompasses the progression and continuation of the ITP and is designed to systemically allow the athlete to progress to unrestricted throwing activities. It is important for the clinician to continuously monitor and assess the athlete’s mechanics and intensity of effort throughout the throwing program. Position players progress throughout the throwing …

Shoulder Rehab Phase 3: Advanced Strengthening Phase The advanced strengthening phase is designed to initiate aggressive strengthening exercises, augment power and endurance, advance functional drills, and gradually initiate throwing activities. Full shoulder ROM and flexibility should be maintained throughout this phase; failure to maintain motion and flexibility at this point is a potential pitfall that can result in recurrent symptoms. Muscle fatigue has been shown to decrease neuromuscular …

Phase 2: Intermediate Phase Along with progression of the strengthening program, the goals of the second phase in dealing with patients with shoulder pain, is to increase the flexibility, mobility, and ROM of the shoulder joint complex and enhance the patients’ overall neuromuscular control. An EMG data driven exercise program designed by Wilk et al, the Thrower’s Ten, is implemented during this stage to permit a …

The rehabilitation of the shoulder has evolved over the past 20 years. In the past, the rehab program focused on strengthening the rotator cuff muscles. Then Dr. Kibler and others taught us to also treat the scapular muscles and scapula posture. Since then numerous articles have been published suggesting GIRD (glenohumeral joint internal rotation deficit) was the cause of shoulder …