Post-op rehabilitation program for arthroscopic AC joint excision

Problem: degenerate AC joint with reduced range of movement and shoulder pain

Aim: to increase range of movement and reduce pain

Important points: wean out of sling by day 5 if possible

Forbidden:

  • heavy activities or heavy work before 6 weeks
  • no heavy activities or sport above shoulder height and arm pulled back for 6 weeks (ABER position)

Expectations:

  • return to desk jobs at 10 days
  • driving from end of week four (if pain and function allows safe driving)
  • breaststroke swimming at 6 weeks
  • non-contact sports and freestyle swimming at 3 months
  • contact and racquet sports at 6 months

Physiotherapy protocol day 1 onwards:

  • Ensure adequate pain relief, neurovascular status normal and no signs of infection
  • Hand and elbows exercises
  • Pendulums and circles
  • Active external rotation to neutral
  • Shoulder shrugs and scapular exercises

Physiotherapy protocol day 7 onwards:

  • Progress passive and active range of movement exercises
  • Isometric strengthening
  • Passive external rotation as pain allows
  • Manual therapy techniques may speed up progression

Physiotherapy protocol day 21 onwards:

  • Progress range of movement from 50% to 100% by 6 weeks
  • Avoid horizontal adduction
  • Progress strengthening

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