Arthroscopic Sub-Acromial Decompression
Wear sling as needed for rest and pain relief for approx. 1 week. May remove for washing, dressing and exercises as comfort allows, ideally in the first 1-2 days.
Exercises and advice sheet given by physio i.e. active assisted exercises, GHJ – elevation and lateral rotation, posture, scapula setting.
Commence low effort isometric contractions for 5 sec hold – initially ant/post deltoid then med rotation and lateral rotation if pain free.
No limitations in range of movement. Active exercises dependant on pain limitation and muscle control of movement.
Care of sling and washing techniques.
Removal of sling for gentle exercises advised 4 times/day.
Shoulder active-assisted movements can be progressed to active exercises, from approximately 10/7 to 2/52, pain dependant (particularly abduction through scaption, elevation & lateral rotation) concentrating on quality as well as ROM.
DO NOT UNDERESTIMATE WEIGHT OF ARM
Continue isometric ant/post deltoid, MR & LR 5 sec hold thro range.
Light Resisted cuff exercises can be introduced through range ensuring good quality of scapula and gleno-humeral joint remains centred thro range. Only introduce light resistance once full pain free ROM regained. N.B. Care with resisted concentric lateral rotation, ensuring pain is not reproduced (If painful you could try eccentric lateral rotation). Free weights of one kilo to perform short lever scaption exercises (W exercise) with high repetition is excellent for activation of rotator cuff..
6 weeks +
Functional and sports specific rotator cuff and scapular training through range, to include proprioception. No restriction but still guided by pain and control of rotator cuff to maintain humeral head centring through the movement.
Return to work: Sedentary 2-3 weeks (as pain allows). Physical 6-8 weeks (as pain allows).
Driving: From 2 weeks (as pain and range allows) patient confirms they are able to drive safely.
Sport: Non contact 2-3 months. Contact 3-6 months
Swimming: Gentle with modified stroke 3-4 weeks. Freestyle 8-12 weeks
General Goals: FROM by 6/52 Cuff strength regained by 3/12