AC Joint Reconstruction — Acromioclavicular (AC) Joint Reconstruction

Mammoth Orthopedic Institute / Mammoth Hospital PT · Timothy Crall MD; Lance Georgeson PT

Weight-Bearing

N/A (shoulder) — sling at all times including sleep x6 weeks

Key Restrictions

Sling x6 weeks; no active abduction or forward elevation x6 weeks; NO PENDULUMS or hanging exercises; all exercises in supine x6 weeks; no distracting (carrying weights) or compressive (bench press/push-up) forces to AC joint after sling DC; band resistance recommended over dumbbells; avoid wide grip bench press and behind-neck military press; MD clearance required for WB exercises and cycling; low rep/high weight avoided indefinitely

Timeline & Phases

4 phases: Phase I (0-6 wks, sling x6 wks, supine PROM/AAROM only, no pendulums, scapular retraction/depression), Phase II (6 wks-3 months, DC sling, upright PROM/AAROM/AROM, isometrics progressing to RC band resistance), Phase III (3-6 months, full ROM, high rep/low weight strengthening, periscapular focus), Phase IV (6-9 months, advanced strengthening, functional training, swimming/tennis/throwing program, RTS with MD approval)

Notes

References Crall previous AC reconstruction protocol; Crall MD and Lance Georgeson PT 9/2025; RTS criteria: full functional ROM, no pain/tenderness, symmetric strength with MD approval; low rep/high weight avoided indefinitely; no pendulums is a key distinction from other shoulder protocols

Surgeon / Author

Timothy Crall MD; Lance Georgeson PT

Published

September 2025