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.


Post Operation:

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.

6 Weeks

  • 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

Racquet sports           

  • 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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