Latarjet Procedure Rehabilitation.
What is the Latarjet procedure?
The Latarjet procedure is a surgical technique for treating recurrent shoulder instability — specifically anterior glenohumeral instability where the shoulder repeatedly dislocates or subluxes forward — in patients where significant bone loss on the glenoid (the socket of the shoulder) makes a simpler soft tissue repair insufficient. It is named after the French surgeon Michel Latarjet who first described it in 1954, and has become one of the most reliably effective surgical treatments for recurrent shoulder instability with bone loss.
The procedure transfers the coracoid process — a bony projection at the front of the scapula — along with its attached conjoint tendon, to the front of the glenoid. This achieves two things simultaneously. The bone block increases the surface area of the glenoid socket, effectively deepening it and reducing the likelihood of the humeral head escaping anteriorly. The conjoint tendon — containing the short head of biceps and coracobrachialis — acts as a dynamic sling across the front of the shoulder, actively resisting anterior translation of the humeral head during the positions of arm elevation and external rotation that are most provocative for instability.
Who needs a Latarjet procedure?
The Latarjet is indicated for recurrent anterior shoulder instability — typically following multiple shoulder dislocations — where one or more of the following factors are present: significant glenoid bone loss (typically more than 20 to 25% of the glenoid surface area), significant Hill-Sachs lesion on the humeral head, failure of a previous soft tissue stabilisation procedure (Bankart repair), or high-demand athletes in contact sports where the recurrence risk from a soft tissue repair alone is unacceptably high.
The distinction between the Latarjet and the more common arthroscopic Bankart repair is important for rehabilitation — the Latarjet involves bone transfer and fixation with screws, which means the early rehabilitation must protect the coracoid transfer while it heals to the glenoid, producing a more conservative early phase than the soft tissue-only Bankart repair.
What does rehabilitation involve?
Weeks 0 to 6 — protected phase
The shoulder is immobilised in a sling for four to six weeks following the Latarjet procedure, protecting the coracoid transfer while it heals to the anterior glenoid. The specific sling protocol and permitted movements are determined by your surgeon — the coracoid transfer is secured with screws and the conjoint tendon must not be placed under excessive tension during healing.
External rotation is the most critical movement restriction in the early phase — excessive external rotation tensions the conjoint tendon sling and risks displacing the coracoid transfer before it has healed. Your surgeon will specify the maximum external rotation permitted in the early weeks, and this restriction is respected precisely in all physiotherapy interventions.
Physiotherapy in the protected phase focuses on hand, wrist and elbow exercises to maintain distal upper limb function, gentle pendulum exercises within the permitted range, postural education to prevent forward shoulder posture, and oedema and pain management. Scar management begins once the wound has fully closed.
Weeks 6 to 12 — progressive range of motion
As the coracoid transfer heals and sling restrictions are progressively lifted, active shoulder range of motion is restored — with continued respect for the external rotation precautions that typically remain until 10 to 12 weeks. Elevation and internal rotation are restored first. External rotation is introduced gradually and specifically, reaching the full permitted range as directed by your surgeon's protocol.
Scapular stabiliser retraining — serratus anterior, lower and middle trapezius — builds the dynamic scapular control that is essential for normal shoulder mechanics and protects the Latarjet repair during the increasing functional demands of later rehabilitation. Real time ultrasound guides serratus anterior activation where inhibition from pain and surgery has disrupted normal firing patterns.
Rotator cuff strengthening begins progressively in positions that do not stress the coracoid transfer — initially isometric activation, advancing to isotonic strengthening in progressively challenging positions as healing and range allow.
Weeks 12 to 24 — strengthening and sport-specific rehabilitation
Progressive rotator cuff, deltoid and periscapular strengthening builds the dynamic shoulder stability that is the primary protection against recurrent instability in the longer term. The Latarjet procedure provides excellent bony and soft tissue stability — but the surrounding musculature must be systematically rebuilt to take over the protective role that the repair provides in the early months.
For athletes returning to contact sport — the primary population for whom the Latarjet is performed — sport-specific rehabilitation addresses the specific shoulder positions and loading patterns of the sport before return to full training and competition. Tackling mechanics, throwing technique, overhead position tolerance and the ability to withstand contact in provocative positions are all assessed and progressively reintroduced. Return to full contact sport typically occurs at five to six months post-operatively for the Latarjet procedure.
Functional shoulder stability testing — assessing the ability to resist apprehension in the provocative positions of external rotation and elevation, the strength symmetry between sides, and the specific sport demands — confirms readiness for return to contact before it occurs.
The Latarjet versus Bankart repair — rehabilitation differences
The Latarjet procedure has a longer and more conservative early rehabilitation than the arthroscopic Bankart repair due to the bone transfer component — the coracoid must heal before progressive loading is appropriate. However the long-term outcomes for recurrent instability in high-risk populations are significantly better with the Latarjet than with soft tissue repair alone, making the more conservative early rehabilitation a worthwhile investment.
Clinical Pilates provides an excellent controlled environment for progressive shoulder stabiliser strengthening — the reformer and tower allow precise loading in positions that can be carefully calibrated to the stage of recovery and the specific external rotation restrictions of the protocol. Dry needling manages the periscapular, pectoral and biceps trigger points that develop from the altered shoulder mechanics of the post-operative period.
Our physiotherapists Mauricio Bara and Bethany Kippen both have experience in complex shoulder surgery rehabilitation and are members of the Australian Physiotherapy Association. Mauricio's APA Sports Physiotherapist credentials and experience in contact sport shoulder management are directly relevant to the return-to-sport decision-making central to Latarjet rehabilitation.
To book or find out more, call us on 07 3706 3407 or book online below. We see patients from across Brisbane's southside including Tarragindi, Coorparoo, Holland Park, Greenslopes and Mt Gravatt.
The Latarjet procedure is a surgical technique for treating recurrent shoulder instability — specifically anterior glenohumeral instability where the shoulder repeatedly dislocates or subluxes forward — in patients where significant bone loss on the glenoid (the socket of the shoulder) makes a simpler soft tissue repair insufficient. It is named after the French surgeon Michel Latarjet who first described it in 1954, and has become one of the most reliably effective surgical treatments for recurrent shoulder instability with bone loss.
The procedure transfers the coracoid process — a bony projection at the front of the scapula — along with its attached conjoint tendon, to the front of the glenoid. This achieves two things simultaneously. The bone block increases the surface area of the glenoid socket, effectively deepening it and reducing the likelihood of the humeral head escaping anteriorly. The conjoint tendon — containing the short head of biceps and coracobrachialis — acts as a dynamic sling across the front of the shoulder, actively resisting anterior translation of the humeral head during the positions of arm elevation and external rotation that are most provocative for instability.
Who needs a Latarjet procedure?
The Latarjet is indicated for recurrent anterior shoulder instability — typically following multiple shoulder dislocations — where one or more of the following factors are present: significant glenoid bone loss (typically more than 20 to 25% of the glenoid surface area), significant Hill-Sachs lesion on the humeral head, failure of a previous soft tissue stabilisation procedure (Bankart repair), or high-demand athletes in contact sports where the recurrence risk from a soft tissue repair alone is unacceptably high.
The distinction between the Latarjet and the more common arthroscopic Bankart repair is important for rehabilitation — the Latarjet involves bone transfer and fixation with screws, which means the early rehabilitation must protect the coracoid transfer while it heals to the glenoid, producing a more conservative early phase than the soft tissue-only Bankart repair.
What does rehabilitation involve?
Weeks 0 to 6 — protected phase
The shoulder is immobilised in a sling for four to six weeks following the Latarjet procedure, protecting the coracoid transfer while it heals to the anterior glenoid. The specific sling protocol and permitted movements are determined by your surgeon — the coracoid transfer is secured with screws and the conjoint tendon must not be placed under excessive tension during healing.
External rotation is the most critical movement restriction in the early phase — excessive external rotation tensions the conjoint tendon sling and risks displacing the coracoid transfer before it has healed. Your surgeon will specify the maximum external rotation permitted in the early weeks, and this restriction is respected precisely in all physiotherapy interventions.
Physiotherapy in the protected phase focuses on hand, wrist and elbow exercises to maintain distal upper limb function, gentle pendulum exercises within the permitted range, postural education to prevent forward shoulder posture, and oedema and pain management. Scar management begins once the wound has fully closed.
Weeks 6 to 12 — progressive range of motion
As the coracoid transfer heals and sling restrictions are progressively lifted, active shoulder range of motion is restored — with continued respect for the external rotation precautions that typically remain until 10 to 12 weeks. Elevation and internal rotation are restored first. External rotation is introduced gradually and specifically, reaching the full permitted range as directed by your surgeon's protocol.
Scapular stabiliser retraining — serratus anterior, lower and middle trapezius — builds the dynamic scapular control that is essential for normal shoulder mechanics and protects the Latarjet repair during the increasing functional demands of later rehabilitation. Real time ultrasound guides serratus anterior activation where inhibition from pain and surgery has disrupted normal firing patterns.
Rotator cuff strengthening begins progressively in positions that do not stress the coracoid transfer — initially isometric activation, advancing to isotonic strengthening in progressively challenging positions as healing and range allow.
Weeks 12 to 24 — strengthening and sport-specific rehabilitation
Progressive rotator cuff, deltoid and periscapular strengthening builds the dynamic shoulder stability that is the primary protection against recurrent instability in the longer term. The Latarjet procedure provides excellent bony and soft tissue stability — but the surrounding musculature must be systematically rebuilt to take over the protective role that the repair provides in the early months.
For athletes returning to contact sport — the primary population for whom the Latarjet is performed — sport-specific rehabilitation addresses the specific shoulder positions and loading patterns of the sport before return to full training and competition. Tackling mechanics, throwing technique, overhead position tolerance and the ability to withstand contact in provocative positions are all assessed and progressively reintroduced. Return to full contact sport typically occurs at five to six months post-operatively for the Latarjet procedure.
Functional shoulder stability testing — assessing the ability to resist apprehension in the provocative positions of external rotation and elevation, the strength symmetry between sides, and the specific sport demands — confirms readiness for return to contact before it occurs.
The Latarjet versus Bankart repair — rehabilitation differences
The Latarjet procedure has a longer and more conservative early rehabilitation than the arthroscopic Bankart repair due to the bone transfer component — the coracoid must heal before progressive loading is appropriate. However the long-term outcomes for recurrent instability in high-risk populations are significantly better with the Latarjet than with soft tissue repair alone, making the more conservative early rehabilitation a worthwhile investment.
Clinical Pilates provides an excellent controlled environment for progressive shoulder stabiliser strengthening — the reformer and tower allow precise loading in positions that can be carefully calibrated to the stage of recovery and the specific external rotation restrictions of the protocol. Dry needling manages the periscapular, pectoral and biceps trigger points that develop from the altered shoulder mechanics of the post-operative period.
Our physiotherapists Mauricio Bara and Bethany Kippen both have experience in complex shoulder surgery rehabilitation and are members of the Australian Physiotherapy Association. Mauricio's APA Sports Physiotherapist credentials and experience in contact sport shoulder management are directly relevant to the return-to-sport decision-making central to Latarjet rehabilitation.
To book or find out more, call us on 07 3706 3407 or book online below. We see patients from across Brisbane's southside including Tarragindi, Coorparoo, Holland Park, Greenslopes and Mt Gravatt.
