Subacromial Decompression — Shoulder Arthroscopic Debridement / SAD / DCR

Orthopedic & Sports Medicine Specialists (OSMS)

Weight-Bearing

Sling for comfort 2-4 wks Phase I, fully discontinued Phase II

Key Restrictions

Progression varies depending on patient's work/sport requirements

Timeline & Phases

Phase I (surgery-4 wks): protect operated shoulder, cryotherapy 20 min q2h, sling for comfort, heat before/ice after PT, PROM all planes, grade 1-3 joint mobilizations, AAROM with T-bar/pulleys, instruct family member/friend in daily passive stretching, Codman's exercises/pendulums, scapular clocks, walking/Stairmaster/stationary bike/LE cross-training with sling on; Phase II (4-6 wks): restore AROM, progress shoulder strength/endurance, full sling discontinuation, submaximal isometrics all planes, prone scapular strengthening (rows, extension, horizontal abduction), grade 3-4 joint mobilizations, shoulder AROM, UBE light resistance, rhythmic stabilizations, RTC strengthening, closed chain activities (wall push-ups, 4-point hand walking); Phase III (6+ wks): full shoulder/scapular ROM all planes, muscle activation, progress RTC/scapular strengthening, shoulder PREs, progress overhead tolerance (volleyball, tennis, throwing, swimming), initiate plyometric program (double progressing to single); return to sport generally acceptable 6-8 weeks after surgeon/PT clearance

Notes

OSMS Rehabilitation Guidelines; covers shoulder arthroscopic debridement, subacromial decompression, and/or distal clavicle resection; if Worker's Compensation patient needing physically demanding job return, schedule Brief Function Assessment (BFA) at wk14-16 upon MD approval (consider work hardening if BFA failed); references Azar/Beaty/Canale Campbell's Operative Orthopedics (2017), Giangarra & Manske Clinical Orthopedic Rehabilitation (2017), and Maxey & Magnusson Rehabilitation for the Postsurgical Orthopedic Patient (2013)