Shoulder Arthroscopy: Debridement / Sub-Acromial Decompression / Distal Clavicle Resection
0-2 Weeks Post Op
- Modalities as needed
- Sling until follow up with physician
- RC isometrics into flexion, extension, abduction, adduction, IR/ER in neutral
- Scapular ex’s – elevation with shrugs, depression, protraction, retraction with manual resistance
- PROM with shoulder pulleys
- Flexion to 90°
- Abduction to 90°
- IR to 90°
- ER to 45°
- Avoid horizontal adduction stretching for 6 weeks with Distal Clavicle Resection
3 Weeks Post Op
- as above
- Begin AAROM ex’s supine or standing with wand or wall walks
- RC ex’s IR/ER with T-band or tubing with arm abducted 20-30°
4 Weeks Post Op
- Continue as above
- Advance ROM as tolerated
- Begin isotonics for Core RC strengthening advance the weight on all ex’s to 6-8lbs, 5-6 sets of 15-20 reps
- Flexion with thumb up – arm at 90°, flex arm forward fully,12 O’clock position
- Abduction to 100°with thumb up — arm at 90° in prone, abduct arm into scapular plane level
with body, 2 O’clock position for right handed patients
- Abduction to 45° with thumb up – arm at 90°in prone, abduct arm level with body,
4 O’clock position for right handed patients
- Extension with arm at max ER – arm at 90° in prone, extend arm to level of body,
6 O’clock position
- Scaption to 90° thumb pointing up, elevate arm in plane of scapula (empty can position)
- Scaption to 60° thumb pointing down, elevate arm same as above but stop at 60°
- Standing or Side lying ER externally rotate arm in 20-30° abduction (pillow helps with position)
- Begin isotonics for peri-scapular strengthening progress as heavy as tolerated
- Elevation – continue with shrugs vertical motion only do not roll shoulders
- Depression – seated press ups hands at hips flat on floor, elbows locked, lift bottom off floor while moving only from scapulas, (not a dip motion), use hand blocks to increase height when able
- Protraction – supine – 2” punches – arm flexed to 90°, elbow locked, motion is from scapula as arm is “punched” forwards, use hand weights, move to push ups with a plus (push up position and perform same movement with body weight) when able
- Retraction – prone rows arm at 90°, elbow locked out or bent to 90°, use hand weight and retract scapula pinching them together
- Proprioception ex’s – rhythmic stabilization, physioball balance ex’s etc
6 Weeks Post Op
- Continue as above
- Full pain free ROM
- Begin conventional weight lifting with machine weights and progress slowly to free weights as desired
- Full ROM isokinetics (throwing wand for throwers) and advance to higher speeds when able
8 Weeks Post Op
- Continue with strengthening
- Begin interval throwing program if strength test passed
Return to Sport/Activity
- When cleared by physician
- Passing strength test if requested
- Completion of throwing program if requested
- NO pain with full ROM (Neer or Hawkins tests (-))