Shoulder and Elbow Surgeon


Arthroscopic Sub-Acromial Decompression (ASAD) +/- Acromio-Clavicular Joint (ACJ) Excision Rehabilitation Protocol.
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The guidelines are the same whether an Arthroscopic Sub-Acromial Decompression (ASAD) is performed in isolation or in conjunction with Acromio-Clavicular Joint (ACJ) excision.

The aim of rehabilitation is to optimise function in the long-term.

General Points:
Do not push through pain.
Do not sacrifice quality of movement for range of movement.
Exercises should be pain free, but should challenge stamina.

Regain range of movement of all affected joints.
Rehabilitate all aspects of rotator cuff function, control, strength and stamina.
Address general strengthening and core stability.
Postural re-education – at work and leisure.
Assess and treat other associated areas as necessary, such as the cervical and thoracic spine.

No formal period of immobilisation is required.
A sling is provided for comfort only.
Wean out of sling as soon as this is tolerated, preferably within 24 to 48 hours.

Post Operative Instructions:

From day 1:
Hand, Wrist and Elbow exercises.
Pendular exercises.

Active assisted exercises.
Encourage optimal Scapulo-Thoracic position.

There are no specific time scales, progression occurs as symptoms and Range Of Movement (ROM) allows.

Functional Milestones and Activity Time Scales:

Driving - See general principles of rehabilitation but typically at approximately 2 weeks.
Light work, sedentary - The patient may need 10 – 14 days but may return sooner if pain and function allow.
Heavy work or sustained over -head postures - Typically 6 weeks but a minimum of 3 weeks depending on symptoms.
Non contact sports - As comfort and ROM allows.
Contact sports – Typically 6-8 weeks as comfort and ROM allows.

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