Subacromial Decompression +/- ACJ Excision
Evidence of inflammation or scuffing on the under surface of the acromion, coracoacromial ligament and on the bursal side of the rotator cuff (i.e. presence of impingement)
- Removal of bone from the acromion & partial resection of the coracoacromial ligament.
- The AC joint remains intact unless excision is required due to pain localising to this site when the distal clavicle and part of the acromion is removed.
- The superior AC ligament remains intact so that the joint remains stable.
On Discharge from Hospital
- Immobiliser (This should be removed within the first 2-3 days)
- Post-op Exercises on discharge
- Active (assisted) glenohumeral movement in all planes
- Teach postural awareness and scapular setting
Out patient Physio
- Begin isometric strengthening (progress using pain & ROM as the limiting factor)
- Rotator cuff strengthening
- Address posterior capsular tightness (sleeper stretch and cross-shest adduction)
- Over zealous physio or repetitive sustained overhead activity could lead to delayed healing & pain
- Manual therapy if required to increase range of movement
- Full recovery can take 6-9 months.
- Expect 80% improvement by 3 months.
- Full active ROM or equivalent to the pre op range
Caution: Any significant increase in pain or decrease in ROM arrange a clinic appointment for a review.
Return to functional activities
Return to work
- Sedentary job: as tolerated
- Manual job: may need to modify activities for 3 months
- 4 weeks
- Breaststroke: as able
- Freestyle: 12 weeks
- 6 weeks
- as able
- Avoid repetitive overhead shots for 3 months
Contact Sport (e.g. Rugby, Rugby League, AFL football, martial arts, racket sports and Surfing)
- 3 months
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