Subacromial decompression and ACJ excision

Arthroscopic Subacromial Decompression + Arthroscopic Excision of Distal Clavicle (ACJ resection)


  •  On Ward

Wear sling as needed for rest and pain relief for approx. 2 days.

Avoid axial loading through upper limb.

Exercises and advice sheet given by physio i.e. active assisted exercises, GHJ – elevation and lateral rotation, posture, scapula setting and isometric cuff.  No limitations in range of movement BUT active exercises dependant on pain limitation and muscle control of movement. – do not encourage full range into pain. Most patients remain below 90 degrees AROM in first 2-3 weeks.

Care of sling and washing techniques.

Removal of sling for gentle exercises advised 4 times/day.

May be limited by pain but can progress > 90° elevation after the first 2/52.  No restrictions in ROM, dependant on active muscle control and pain.


  • 2-6 weeks

Progress as subacromial decompression. Patients may be have more pain at end range elevation than standard ASAD so progress may be slower with longer rehabilitation time.


  • 6 weeks +

Functional and sports specific rotator cuff and scapular training through range, to include proprioception.


  • Return to work: Sedentary 2-3 weeks (as pain allows). Physical 4-6 weeks (as pain allows).


  • Driving:  2 weeks (as pain and range allows) patient confirms they are able to drive safely.


  • Sport:  Non contact 2-3 months. Contact 3-6months


  • Swimming:  Gentle with modified stroke 3-4 weeks. Freestyle 8 weeks


Andrew Cole