Acromioclavicular Separation/Dislocation

Non-operative Acromioclavicular Joint Separation

Phase I: Gradual ROM (Injury to 2 weeks)

• Ice encouraged for the first week at a minimum: should be used 3-4 times per day.
• Sling should be in place for 5-7 days when not performing exercises.
• Initiate exercise program 3 times per day:
• Immediate elbow, forearm and hand range of motion out of sling
• Passive and active assistive ER at the side to 30, flexion to 130
• No lifting with involved extremity.
• AVOID scapular ROM exercises.

Phase II: Progress ROM & Function (2 to 6 weeks)

• May discontinue sling.
• Advance active and passive ROM in all planes to tolerance.
• Lifting restriction of 5 pounds with the involved extremity until 4 weeks from injury
• Initiate gentle rotator cuff strengthening; progress to light resistive Theraband exercises.
• Initiate scapular AROM exercises.

Phase III: Full Function (>6 weeks)

• Discontinue all lifting restrictions.
• Advance rotator cuff and scapular stabilizer strengthening.
• Initiate functional progression to sports specific activities at 6-8 weeks.

• Discontinue all lifting restrictions.
• Advance rotator cuff and scapular stabilizer strengthening.
• Initiate functional progression to sports specific activities at 6-8 weeks.

Acute Repair/Reconstruction

Phase I: Protect Repair(0 to 6 weeks after surgery)

• Patients may shower immediately over clear plastic, waterproof dressing
• Sutures are all underneath the skin and will dissolve on their own
• Ice or cold flow systems encouraged for the first week at a minimum: should be used 3-4 times per day.
• Sling should be worn at all times.
• Initiate exercise program:
  • Immediate elbow, forearm and hand range of motion out of sling
• No lifting with involved extremity.
• AVOID scapular ROM exercises.

Phase II: Progress ROM & Protect Repair(6 to 12 weeks after surgery)

• May discontinue sling.
• Pendulum exercises
• Passive and active assistive ER at the side to 30, flexion to 130
• Initiate gentle rotator cuff strengthening.
• Initiate scapular AROM exercises.

Phase III: Full Function(3 months after surgery)

• Advance active and passive ROM in all planes to tolerance.
• Advance rotator cuff and scapular stabilizer strengthening.
• Initiate functional progression to sports specific activities at 5 months.
• Discontinue lifting restrictions after 5 months

Acromioclavicular Joint Reconstruction (Chronic)

Phase I: Protect Repair (0 to 8 weeks after surgery)

• Patients may shower immediately over clear plastic, waterproof dressing
• Sutures are all underneath the skin and will dissolve on their own
• Ice or cold flow systems encouraged for the first week at a minimum: should be used 3-4 times per day.
• Sling should be in place when not performing exercises.
• Initiate exercise program 3 times per day:

Immediate elbow, forearm and hand range of motion out of sling

Pendulum exercises

Passive and active assistive ER at the side to 30, flexion to 130

• No lifting with involved extremity.
• AVOID scapular ROM exercises.

Phase II: Progress ROM & Protect Repair (8 to 12 weeks after surgery)

• May discontinue sling.
• Lifting restriction of 5 pounds with the involved extremity.
• Advance active and passive ROM in all planes to tolerance.
• Initiate gentle rotator cuff strengthening.
• Initiate scapular AROM exercises.

Phase III: Full Function (3 months after surgery)

• Discontinue lifting restrictions.
• Advance rotator cuff and scapular stabilizer strengthening.
• Initiate functional progression to sports specific activities at 4 months.

AC Joint Reconstruction, Posterior Labral Repair

Phase I: Protect Repair(0 to 6 weeks after surgery)

• Patients may shower immediately over clear plastic, waterproof dressing
• Sutures are all underneath the skin and will dissolve on their own
• Ice or cold flow systems encouraged for the first week at a minimum: should be used 3-4 times per day.
• Sling should be in place when not performing exercises.
• Initiate exercise program 3 times per day:
1. Immediate elbow, forearm and hand range of motion out of sling Pendulum exercises
2. Avoid IR ROM and flexion greater than 90
3. Passive and active assistive ER at the side to 60, scapular plane abduction to 90, flexion to 90 only
• No lifting with involved extremity.
• AVOID scapular ROM exercises.

Phase II: Full Function (3 months after surgery)

• May discontinue sling.
• Lifting restriction of 5 pounds with the involved extremity.
• Avoid IR in abducted position > 30 and cross body shoulder motion
• Advance active and passive ROM:
1. ER at the side and scapular plane elevation to tolerance
2. Flexion to tolerance – shld should be in externally rotated position
3. Extension to tolerance
4. IR from abducted position to 30 degrees
• Initiate gentle rotator cuff strengthening.
• Initiate scapular AROM exercises.

Phase III: Full Function (3 months after surgery)

• Begin combined full flexion and IR from abducted position.
• Discontinue lifting restrictions.
• Advance rotator cuff and scapular stabilizer strengthening.
• Initiate functional progression to sports specific activities at 4 months.

You will need the Adobe Reader to view and print these documents.