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