Post-op rehabilitation program for ACJ reconstruction

Problem: ACJ dislocation with reduced range of movement and shoulder pain

Aim: to stabilise ACJ, increase range of movement and reduce pain

Important points: to remain in sling for four weeks


●     heavy activities or heavy work before 12 weeks

●     no heavy activities or sport above shoulder height and arm pulled back for 3 months (ABER position)


●     return to desk jobs at 3-6 weeks

●     driving at 6-10 weeks (if pain and function allows safe driving)

●     breaststroke swimming at 10 weeks

●     contact sports and freestyle swimming at 4 months

Physiotherapy protocol day 1 onward:

●     Ensure adequate pain relief, neuro-vascular status normal and no signs of infection

●     Hand and elbows exercises

●     Pendulums and circles

●     Active external rotation and internal rotation

●     Shoulder shrugs and scapular exercises

●     Sling for first 4 weeks

Physiotherapy protocol day 21 onward:

●     Begin to wean out of sling over next 3 weeks

●     Begin active assisted forward flexion and abduction

Physiotherapy protocol week 7 onward:

●     Active range of movement throughout

●     Once achieved concentrate on scapular control and strength exercises

Protocol from 4 months onward:

●     Return to sports and full activities if regained full ROM and 90% strength of contra-lateral side

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