Applies to debridement/decompression alone. Start therapy within the first 1–2 weeks as arranged.

After collarbone-end excision, defer cross-body stretching for about 6 weeks unless specifically released. Repair surgery uses a different pathway.

Selected conservative schedule for uncomplicated small/medium repair. Large, revision, or poor-quality repairs require written timing changes.

A repaired subscapularis needs explicit outward-rotation and inward-strengthening limits. Biceps repair restrictions also apply.

Posterior repairs and bone-block surgery use S4, not these rotation limits.

Use this planning schedule only after the surgeon supplies procedure-specific motion limits; the operations do not share identical precautions.

A concurrent cuff repair changes the plan substantially; do not apply this early-motion schedule automatically.

An interval throwing program for baseball players returning after UCL reconstruction (Tommy John surgery) or shoulder surgery. Throwing starts only after the surgeon clears it, and the restrictions in the underlying surgical protocol still apply. Progress is earned by symptom-free sessions and sound mechanics, not by the calendar.

Before throwing begins, all of the following are required:

• Surgeon clearance to start the throwing program.
• Full, pain-free shoulder and elbow motion, with total rotation of the throwing shoulder close to the other side.
• No pain or tenderness at the surgical site and a stable elbow or shoulder on examination.
• Shoulder, shoulder-blade, forearm, and grip strength close to the other side on therapist testing, with good endurance.
• Two-hand, then one-hand plyometric drills completed without pain.
• Core, hip, and leg strength and control adequate for throwing mechanics.

After UCL reconstruction, mound work commonly begins about 6–9 months after surgery, and pitchers commonly return to competition 12–18 months after surgery; position players often return sooner. After shoulder repair, return to competition commonly takes 9–12 months. Completing each phase matters more than reaching a date.

Phase 1 — Long toss on flat ground. Throw every other day, about 3 days a week. Start each session with a dynamic warm-up and light band work for the shoulder, then easy warm-up throws beginning at 30–45 ft and building to the day's distance. Use a crow hop and a controlled arc; the ball should carry just far enough to reach the partner. Rest about 5 minutes between sets. Each stage has two workouts (A, then B). Do each workout at least twice without symptoms before moving to the next.

After UCL reconstruction the long-toss phase usually runs 2–3 months. Spend extra sessions at 90–120 ft rather than rushing distance.

Phase 2 — Flat-ground pitching (pitchers). After completing Stage 4, finish long-toss sessions with flat-ground throws from 60 ft 6 in using full pitching mechanics at about 50% effort: 15, then 25, then 35 throws over successive sessions.

Phase 3 — Mound progression (pitchers). Warm up with long toss to 120 ft before every mound session. Separate mound sessions by at least one day of light long toss or rest. In any one session, increase either the pitch count or the effort, never both. A radar gun helps control effort: perceived effort usually runs high, so a "50% effort" pitch is often much faster than half of normal velocity. All mound work should be watched by a pitching coach or therapist for mechanics.

Advance only when the previous session was symptom-free by the soreness rules below, mechanics and command held through the final pitches, and velocity matched the effort level.

Position players: after reaching their final long-toss distance, throw from their position at about 50%, then 75%, then full effort. Infielders progress to quick-release and across-the-diamond throws; outfielders to crow-hop throws to bases and cutoffs; catchers from standing throws to throws from the crouch. Then progress to practice and games with surgeon clearance.

Soreness rules

Between throwing days: continue the rotator cuff and shoulder-blade program, forearm and grip strengthening, posterior shoulder mobility, and core and lower-body training. A light band warm-up before throwing is fine; heavier arm strengthening belongs after throwing or on non-throwing days.

Tracking: log every session, including the date, stage, distance, throw or pitch count, effort (and radar velocity if used), and any soreness.

Hitting: the surgeon sets the start date. Progress from dry swings to tee work, soft toss, and then live pitching.

This program is for baseball throwing. Windmill softball pitchers and other overhead athletes, such as volleyball, tennis, and javelin, need a sport-specific program.

No meniscus stitches, microfracture, or cartilage graft.

The tear-specific early restrictions are essential, not optional modifiers.

This schedule uses a conservative return to impact.

These complex repairs need explicit early orders; isolated ACL instructions are not interchangeable.

This is an exercise framework; the exact operation must supply the protection schedule.

Partial knee replacement may progress faster, but the wound, swelling, and function still govern. Routine continuous passive motion is not a replacement for active therapy.

Do not combine posterior and anterior hip precautions. Abductor repair or fracture changes this schedule.

Fracture replacement/tuberosity repair requires separate protection.

Phase divisions here are planning checkpoints; triceps technique controls activation timing.

Cartilage procedures can prolong protection.

Selected protected-motion schedule; the surgeon must approve wedge removal and weight-bearing dates.

Nonoperative rupture must use the treating team's separate boot schedule.

The schedule below is a conservative planning framework. Internal-brace augmentation may permit earlier activity; it does not automatically authorize it.

Debridement alone can have a faster schedule and should be ordered separately.

Use after the surgeon specifies fused joints, repaired tendons, and loading restrictions.

These timelines are review windows, not shared union dates.

The operation-specific loading and toe-position orders remain necessary.

Weeks count from evaluation; severe sprains can take longer.

This is a conservative shared release pathway, not a tendon-repair program.

The phase boundaries are practice planning points; technique-specific orders prevail.

Suspensionplasty or implant techniques may use a different schedule.

Wrist ligament reconstruction with pins needs a dedicated schedule.

Entry requirements: surgeon prescribes this program; repair has at least four strands; therapy begins before postoperative day 10; swelling/stiffness does not prevent gentle glide. Otherwise obtain the appropriate alternative protocol.

The hand therapist must provide the prescribed orthosis angles and exact exercise sequence before this program starts. Sudden loss of active bending requires urgent surgical contact.

For selected back-of-hand repairs only; not mallet finger, central-slip injury, or injury to all relevant extensor tendons.

The hand therapist must fit the orthosis and teach the exact exercise sequence before this program starts. Hand therapist sets dose; general strength dosing does not apply initially.

These repairs need different activation dates; the schedule is organized around the written release rather than one interchangeable muscle rule.

For stable or surgically stabilized proximal/middle phalanx fractures. Weeks count from injury for nonsurgical care and surgery for fixation; the treating team confirms the applicable healing stage.

Exercise dose: begin approved active motion with 5–10 gentle repetitions, 4–6 short sessions daily; therapist adjusts this starting proposal. New finger crossing, worsening straightening, or increasing focal pain needs review.

Distal tuft fracture: fingertip protection commonly lasts 2–3 weeks, with the middle finger joint kept moving. After release, add gentle tip-joint motion and light use. Mallet-type fractures, tendon avulsions, unstable joint fractures, and associated tendon repairs require their own protection schedule.

Strengthening depends on healing and clearance.

For uncomplicated second-to-fifth metacarpal fractures managed with protection or stable fixation. Thumb-base fractures and unstable joint injuries require a specific surgical plan. Count weeks from injury for nonsurgical care and surgery for fixation.

Exercise dose: begin approved active motion with 5–10 repetitions, 4–6 short sessions daily. For cleared resistance, start with 1–2 sets of 10 on alternate days. These are starting proposals; do not force a tight fist through pain.

Fracture pattern and fixation determine whether early motion and later loading are appropriate.

Starting dates depend on fracture stability and treatment.

Radial-head, olecranon, and ligament injuries require their own early settings.

Immediate weight bearing as tolerated may be considered in older adults after surgery, but it still must be ordered. Arthroplasty precautions apply where prescribed.

Femoral and nail constructs need their exact fixation-specific orders.