AC Reconstruction

Acromioclavicular Joint Reconstruction Using Synthetic Material Accelerated Rehabilitation Protocol (for Athletes)
I.
PHASE I MOTION PHASE (Weeks 0-2) Goals: Initiate ROM exercises Retard muscular atrophy Decrease pain/inflammation Range of Motion Exercises: L-bar AAROM Flexion to tolerance ER/IR (begin at 45 degrees abduction, progress to 90 degrees abduction) motion to tolerance Rope and pulley scaption Pendulum exercises Self-capsular stretches *Note Restrict horizontal Abduction/Adduction (often painful) Strengthening Exercises: Isometrics ER, IR, Abd, Ext, Biceps, Triceps *Note No resisted shoulder flexion Initiate ER/IR with exercise tubing at 0 degrees abduction when pain free (usually week 2) Decrease Pain/Inflammation: Ice, NSAIDS, modalities Ice applied directly over AC joint
II.
PHASE II INTERMEDIATE PHASE (Weeks 3-8) Goals: Gradually regain full ROM Regain and improve muscular strength Normalize arthrokinematics Improve neuromuscular control of shoulder complex Criteria to Progress to Phase II: 1) Nearly full ROM 2) Minimal pain and tenderness 3) Stable AC joint on clinical exam 4) Good (4/5) MMT of ER/IR/Abd
Week 3 Range of Motion Exercises: Continue AAROM with L-bar Shoulder elevation to at least 160 degrees by week 4 ER/IR at 90 degrees abduction full ROM
Page 2 of 3
Strengthening Exercises: Initiate isotonic strengthening (light resistance) Shoulder abduction Shoulder extension Shoulder ER/IR tubing Sidelying ER Biceps/triceps Prone horizontal abduction Prone rowing Prone extension *Note Restricted shoulder flexion prohibited (for 4 weeks) Initiate neuromuscular control exercises (PNF) Initiate manual resistance Continue use of modalities, ice as needed
Week 6 Range of motion exercises: Continue stretching program Strengthening exercises: Continue all strengthening exercises listed above Initiate light resistance shoulder flexion Initiate upper extremity endurance exercises Initiate light isotonic resistance progression NO shoulder press or bench press or pect deck or pullovers Rhythmic stabilization exercise for shoulder flexion/extension Program all shoulder and scapular strengthening exercises
III.
PHASE III DYNAMIC STRENGTHENING PHASE (Weeks 8-16) Goals: Improve strength/power/endurance Improve neuromuscular control/dynamic stability to the AC joint Prepare athlete for overhead motion Criteria to Enter Phase III: 1. Full nonpainful ROM 2. No pain or tenderness 3. Strength 70% of contralateral side Strengthening Exercises: Continue isotonic strengthening exercises Initiate light bench press, shoulder press (progress weight slowly) Continue with resistance exercises for: Shoulder abduction Shoulder ER/IR Shoulder flexion Latissimus dorsi (rowing, pull-downs) Biceps/triceps Initiate tubing PNF patterns Initiate ER/IR at 90 degrees abduction Scapular strengthening (4 directions) Emphasis on scapular retractors, elevators Neuromuscular control exercises for glenohumeral and scapulothoracic joints Rhythmic stabilization
Copyright 2004-2010 by the Advanced Continuing Education Institute, LLC. www.AdvancedCEU.com. All Rights Reserved. Any redistribution, alteration, or reproduction of any materials herein is strictly prohibited.
Page 3 of 3 Shoulder flexion/extension Shoulder ER/IR (90/90) Shoulder abduction/adduction PNF D2 patterns Scapular retract/protract Scapular elev/depress Program to plyometric upper extremity exercises Continue stretching to maintain mobility
IV,
PHASE IV RETURN TO ACTIVITY PHASE (Week 16>)
Goals: Progressively increase activities to prepare patient/athlete to full functional return Criteria to Progress to Phase IV: 1) Full nonpainful ROM 2) No pain or tenderness 3) Isokinetic test that fulfills criteria (Shoulder F/E, Abd/Add) 4) Satisfactory clinical exam Initiate Interval Sports Program Continue all exercises listed in Phase III Progress resistance exercise levels and stretching
Copyright 2004-2010 by the Advanced Continuing Education Institute, LLC. www.AdvancedCEU.com. All Rights Reserved. Any redistribution, alteration, or reproduction of any materials herein is strictly prohibited.

AC Reconstruction

Uploaded by

Copyright:

Available Formats

AC Reconstruction

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

AC Reconstruction

Uploaded by

Copyright:

Available Formats

Acromioclavicular Joint Reconstruction Using Synthetic Material Accelerated Rehabilitation Protocol (for Athletes)

PHASE IV RETURN TO ACTIVITY PHASE (Week 16>)

You might also like