AC Joint Reconstruction Rehab Protocol

Keys to a Successful Outcome

  • Avoid excessive reaching and external/internal rotation for the first 6 weeks.

  • Do not elevate the surgical arm above 70 degrees in any plane for the first 4 weeks.

  • Do not lift any objects above 5 pounds for the first 6 weeks.

Phase
Brace
ROM
WB
Exercise
Weeks 0-6*
Worn at all times**
No shoulder A/AAROM; gentle PROM week 2; limitations: FF 90°, ABD 80°, EXT 0°, ER/IR 45° (w/arm in 45°ABD), scapular retraction
NWB
Gentle shoulder pendulum exercises w/ therapist; elbow/wrist/hand ROM and grip strengthening; begin isometrics when comfortable
Weeks 6-12
None
Can begin PROM->AAROM->AROM; Increase ROM parameters by 15° per week IF NOT PAINFUL
NWB
No resistance exercises other than pain-free isometric exercises (deltoid, RTC), wall slides, gentle RTC and scapular strengthening @ 8 weeks, no pushing exercises
Months 3-6
None
Gradual return to full AROM; humeral head stabilization; horizontal adduction stretch okay, IR behind back OK
PWB
Advance strengthening as tolerated: isometrics->therabands->light weights; initiate push-ups onto wall; scapular and latissimus strengthening; seated bench @ week 16
Months 6-9
None
FAROM
WBAT
Progress with exercises as tolerated without restrictions

* No horizontal adduction until 6 weeks.  At 6 weeks, active horizontal only until week 12.  At week 12, can initiate horizontal adduction stretch.

**Worn day and night and off for hygiene and exercises only, avoid unsupported arm