Post-op rehabilitation program for arthroscopic sub-acromial decompression

 

Problem: impingement syndrome 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 5 weeks
  • no heavy activities or sport above shoulder height and arm pulled back for 3 months (ABER position)

 

Expectations:

  • return to desk jobs at 10 days
  • driving from end of week two (if pain and function allows safe driving)
  • breaststroke swimming at 3 weeks
  • golf  and freestyle swimming at 6 weeks

 

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
  • Shoulder shrugs and scapular exercises
  • Begin active assisted movements if possible

 

Physiotherapy protocol day 7 onwards:

  • Progress passive and active range of movement exercises
  • Isometric strengthening
  • Manual therapy techniques may speed up progression

 

Physiotherapy protocol day 21 onwards:

  • Continue to progress range of movement and strength
  • May take up to 3 months to progress through regime

 

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