AC Joint Separation Rehabilitation Protocol

Phase One

  • Decrease pain.

  • Active assisted ROM to include elevation and depression of the arm in the plane of the

    scapula.

  • Do not go beyond the limit where the pain begins

  • Modalities

  • Isometric flexion/extension.

  • Criteria to advance to Phase 2

    • o 75% of FROM compared to opposite shoulder o Minimal pain on palpation of the AC joint
    • MMT of 4/5 of the deltoid

Phase Two

  • Advance patient to full painless ROM and increase strength in an isotonic arc.

  • Active assisted ROM with arm at the side and at 90deg of abduction.

  • Deltoid, trapezius, and cuff strengthening.

  • Avoid bench press

  • Criteria to advance to Phase 3

    • Painless ROM
    • Pain free palpation of the AC joint
    • 75% strength of the opposite shoulder.

Phase Three

  • Increase strength of the entire shoulder complex musculature

  • Isotonic dumbbell shoulder flexion, abduction, shrugs, and bench press

  • Progress to Plyometric drills of the upper extremity

  • Criteria to advance to Phase 4

    • FROM
    • No pain
    • Satisfactory clinical exam
    • Near 100% isokinetic strength compared to the opposite shoulder (testing done at 180 degrees per second and 300deg/sec).

Phase Four

  • Sport specific exercises
 
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