Acromio clavicular Joint Reconstruction or Weaver-Dunn procedure
Sling for up to 4-6/52 for pain relief. Only to be removed for washing, dressing and exercise.
Day 1 on ward - Active assisted elevation 0-60° in forward lean standing (assisted pendula elevation). Teach elbow, wrist and hand exercises.
Care NOT to hitch scapula.
Teach sling care and washing.
Active External Rotation as pain allows.
N.B. AVOID axial loading for 3/12. NO long lever strengthening for 3/12.
Shoulder clinic review @ 6/52 to discuss progression then 6/12 review
Aim for controlled quality early motion to 90° by 6/52, pain limiting. N.B. CARE not to impinge rotator cuff. May use ball rolls on table for early movement with arm supported.
Early Isometric Rotator Cuff activation after 4/52 – GHJ in neutral i.e) ant / post deltoid, medial and lateral rotation – light resistance (30% MVC) and pain free.
Regain FROM as pain allows keeping humeral head centred and avoiding early scapula movement.
Short lever scaption exercises with thumb leading ; example w,W, and Y.
No long lever strengthening > 3/12. Progress controlled rotator cuff and deltoid activation 6-12/52.
No resistance exercises with night pain still present, can do isometric exercises.
Ensure scapular dynamic control through full range of movement.
No heavy lifting before 3 months.
This is a general guide, please check specific post-op instructions before commencing rehabilitation.
Return to work: Sedentary 6 weeks (as pain allows). Physical 3-4 months (as guided by surgeon).
Driving: 6-8 weeks (as pain and range allows) patient confirms safety to drive.
Sport: Non contact 3 months. Contact 6-9 months (as guided by surgeon).
Swimming: Gentle with modified stroke 8-10 weeks. Freestyle 4-6 months.