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Arthroscopic subacromial decompression

Considerations for physiotherapy

For arthroscopic procedures there are no specific structures that need to be protected during the early phase of rehabilitation. It is important however to remember that the subacromial structures will still be sensitive and painful as a result of impingement processes that have been ongoing pre-operatively. For this reason, although there are no specific post-operative restrictions it remains important to respect the patient's symptoms and gradually regain range of movement accordingly.

Post-operative instructions must be checked for variations from the standard protocol. The surgeon may have proceeded to a rotator cuff repair, in this case the rotator cuff repair protocol should be followed.

 

Pre-operatively

Range of movement and muscle strength are assessed.

Post operative protocol explained

Physiotherapy outpatient appointment arranged.

 

Day 1

Polysling with body belt for comfort and pain relief only. Encourage self weaning from sling over the next few days as comfort allows.

Removal and replacement of polysling taught

Elbow, radioulnar, wrist and hand maintenance exercises

Pendular exercises

 

Out patient rehabilitation

Passive, active assisted and active movements of the shoulder in all directions aiming for full range of movement over 6 weeks.

Progress to strengthening of the rotator cuff initially in the scapular plane and progressing to cuff strengthening through range as the patient's symptoms and strength improves.

Return to functional activities

 

Driving

Patients can begin driving when they have sufficient pain free active movement and good strength and control

 

Return to work

Dependent on patient's job. Patients in sedentary jobs may usually return to work after 2 weeks. Manual workers may require more specific rehabilitation and strength work to enable them to cope with the functional demands of their job.

 

Sports

This depends on the sport, sufficient flexibility and muscle strength for the activities required must be considered before a gradual increase in participation is allowed. Swimming breast stroke is a useful activity early on in rehabilitation and can be started as soon as the wounds are healed and dry.

 

 

 

 

 

 

 

Shoulder Conditions

Elbow Conditons