Acromioclavicular Joint Reconstruction
Phase One: 0-6 Weeks Post-Op
Goals:
- Protect the surgical repair
- Ensure wound healing
- Prevent shoulder stiffness
- Control pain and swelling
Restrictions:
- Sling at all times outside of showering and PT exercises
- No ROM above 90 degrees in any plane
- Do not lift above 1-2 lbs with the surgical arm
Exercises:
- Supine external rotation
- Supine AAROM Flexion to 90 degrees
- Pendulums
- Isometric IR/ER at neutral
- Elbow and forearm exercises
- Ball squeezes
- Scapular retraction
Phase Two: 7-12 Weeks Post-Op
Goals:
- Protect surgical repair
- Improve range of motion of the shoulder
- Begin gentle strengthening
Restrictions:
- Discontinue and wean out of sling
- Avoid lifting more than 1-2 lbs, forceful pushing/pulling activities, and reaching behind you.
Stretching/Active Motion:
- Supine and standing ER
- Supine AAROM flexion
- Flexion in scapular plane
- Behind back IR- limit beltline
- Horizontal adduction (active reach only)
- Hands behind the head stretch
- ER at 90 degrees abduction stretch
- Proprioception drills
- Side lying IR at 90 degrees
Exercises:
- Internal/External rotation
- Bicep curl
- Forward Punch (Serratus punch)
- Side lying ER
- Prone/Standing Rows
- Prone extension/ T’s / Y’s
- Standing scaption
- Rhythmic Stabilization
- Scapulohumeral rhythm exercises
- Begin wall push ups at 12 weeks, progress per MD to normal push ups
Phase Three: 13 to 18 Weeks Post Op
Goals:
- Protect the surgical repair
- Regain full range of motion
- Continue strengthening progression
Restrictions:
- Avoid lifting heavy weight outside the frame of the body/overhead and forceful pushing/pulling
Stretching/Range of Motion:
- Standing ER/Doorway stretch
- Wall Slide stretch
- Hands-behind-head stretch
- Standing forward flexion
- Behind the back internal rotation
- Supine cross-chest stretch
- Sidelying internal rotation (sleeper stretch)
- ER at 90 degrees
Exercises: Add progressive weight 1-5 lbs
- External/internal rotation theraband
- Standing forward punch
- Shoulder shrug
- Dynamic hug
- Seated Row
- Biceps Curl
- Standing W’s
- Side-lying ER
- Prone T’s/Rows/Scaption/Y’s/ extension
- Standing Full- Can scaption
- Rhythmic stabilization and proprioception training drills
- Limited weight training can begin after 16 weeks per surgeon clearance
Phase Four: 19-28 Week Post-Op
Goals:
- Progression of functional activities
- Maintain full range of motion
- Continue progressive strengthening
- Advance sport and recreational activity per surgeon
Stretching/ Range of Motion: continue from phase 3
Exercises: Continue from phase 3 and add following plyometric program if applicable to their recreational/sport activities
- Rebounder throws
- Wall Dribbles overhead
- Rebounder throwing/weighted ball
- Deceleration drills with weighted ball
- Wall dribbles at 90 degrees
- Wall dribble circles