Arthroscopic Subacromial Decompression/Distal Clavicle Excision
Phase I (Weeks 0-4)
- Sling immobilization for comfort Weeks 0-2 – Discontinue sling use at 2 weeks
- Range of Motion –PROM -> AAROM -> AROM as toleratedGoals: 140° of Forward Flexion, 40° of External Rotation at side, Internal Rotation behind back with gentle posterior capsular stretchingNo abduction-external or internal rotation (90/90) until 4-8 weeks post-op
- Goals: 140° of Forward Flexion, 40° of External Rotation at side, Internal Rotation behind back with gentle posterior capsular stretching
- No abduction-external or internal rotation (90/90) until 4-8 weeks post-op
- Therapeutic ExerciseCodman’s/Pulleys/CaneElbow/Wrist/Hand Range of MotionGrip StrengtheningNo resistive exercises
- Codman’s/Pulleys/Cane
- Elbow/Wrist/Hand Range of Motion
- Grip Strengthening
- No resistive exercises
- Heat/Ice before and after PT sessions
Phase II (Weeks 4-8)
- Range of Motion – Increase Forward Flexion, Internal/External Rotation to full motion as toleratedGoals: 160° of Forward Flexion, 60° of External Rotation at side, Internal Rotation behind back and at 90° of abduction with gentle posterior capsular stretching
- Goals: 160° of Forward Flexion, 60° of External Rotation at side, Internal Rotation behind back and at 90° of abduction with gentle posterior capsular stretching
- Therapeutic ExerciseBegin light isometrics with arm at the side for rotator cuff and deltoidAdvance to therabands as toleratedPassive stretching at end range of motion to maintain shoulder flexibility
- Begin light isometrics with arm at the side for rotator cuff and deltoid
- Advance to therabands as tolerated
- Passive stretching at end range of motion to maintain shoulder flexibility
- Modalities per PT discretion
Phase III (Weeks 8-12)
- Range of Motion – Progress to full AROM without discomfort
- Therapeutic Exercise – Advance strengthening as toleratedIsometrics -> therabands -> weightsBegin eccentrically resisted motions, closed chain exercises and plyometrics8-12 repetitions/2-3 sets for Rotator Cuff, Deltoid and Scapular Stabilizers
- Isometrics -> therabands -> weights
- Begin eccentrically resisted motions, closed chain exercises and plyometrics
- 8-12 repetitions/2-3 sets for Rotator Cuff, Deltoid and Scapular Stabilizers
- Modalities per PT discretion