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