Subacromial Decompression Distal Clavicle Excision

PHASE 1: 0-4 WEEKS

• Pendulum exercises only until 1 week post-op
• Wean from sling at 1 week post-op
• ROM: progress from passive to active ROM as tolerated
  • Goal: 140° of forward flexion, 40° ER (at side) at 4 weeks post-op
  • No abduction or 90/90 ER until 4 weeks post-op
    • No horizontal adduction until 4 weeks post-op if distal clavicle rxn
  • Strengthening: grip strengthening, pulleys/canes, Codman’s
    • No resisted motions until 4 weeks post-op

PHASE 2: 4 WEEKS – 8 WEEKS

• ROM: increase ROM as tolerated
  • Goals: 160° forward flexion, 90° abduction at 8 weeks post-op
• May perform horizontal adduction if distal clavicle rxn
• May begin and advance gentle posterior capsule stretching behind back
• Strengthening: light isometrics with elbow at side for rotator cuff/deltoid using theraband

PHASE 3: 2 MONTHS+

• ROM: full ROM w/o discomfort as tolerated
• Strengthening: advance strengthening as tolerated
• May begin eccentric, resisted motions and close chained exercises
• Transition to home exercise program