Subacromial decompression with or without ACJ excision

Protocol

Post op
On Discharge from Hospital

  • Immobiliser (This should be removed within the first 2-3 days
  • Post-op Exercises on discharge
  • Active (assisted) glenohumeral movement in all planes
  • Teach postural awareness and scapular setting

Out patient Physio

Mobility stage I

stage II

Mobility stage I

stage II

 

  • Begin isometric strengthening (progress using pain & ROM as the limiting factor)
  • Rotator cuff strengthening
  • Address posterior capsular tightness (sleeper stretch and cross-chest adduction)
  • Over zealous physio or repetitive sustained overhead activity could lead to delayed healing & pain
  • Manual therapy if required to increase range of movement

Milestones

Full recovery can take 6-9 months.
Expect 80% improvement by 3 months.

6 Weeks

Full active ROM or equivalent to the pre op range

Caution

Any significant increase in pain or decrease in ROM arrange a clinic appointment for a review.

 

Return to functional activities

Return to work Sedentary job: as tolerated,  

Manual job: may need to modify activities for 3 months

Driving 1 week

Swimming Breaststroke: as able.    Freestyle: 12 weeks

Golf 6 weeks

Lifting as able

Racquet sports Avoid repetitive overhead shots for 3 months