AC Joint — Reconstruction

Saint Louis University (SLUCare)

Weight-Bearing

N/A

Key Restrictions

Sling at all times wks 0-6; no shoulder ROM wks 0-4; passive FF limit 140 deg wks 6-10; go SLOW with ER; throwing not until wk 14+; isokinetic IR/ER 85% uninvolved before Phase IV

Timeline & Phases

Wks 0-4: HEP only, sling at all times, no shoulder ROM, AROM wrist/elbow, scapular pinches; Wks 4-6: HEP, sling at all times, passive supine ER to neutral and extension to neutral, passive supine FF to 100 deg, pain-free submaximal deltoid isometrics; Wks 6-10: DC sling, passive and AAFF to 140 deg, passive and AAER no limits (go slow), scapular stabilization, IR/ER isometrics, modalities; advancement criteria: FF 160 deg, ER 40 deg, normal scapulohumeral rhythm; Wks 10-14: AAROM full FF and ER, AAROM IR, IR/ER/FF isotonics, scapular/lat strengthening, humeral head stabilization, biceps, progress IR/ER to 90/90 if required; advancement criteria: full ROM, isokinetic IR/ER 85%; Wks 14-18: full UE strengthening, plyometrics, sport/activity program, throwing program (20-30 ft 60% velocity progressing), isokinetics at high speeds; discharge: isokinetic IR/ER equal to uninvolved, independent HEP, pain-free sport program

Notes

SLU Sports Medicine and Shoulder Service; diagnosis: AC joint instability; coracoclavicular graft (semitendinosus autograft or allograft); 4-month protocol 2-3 visits/week