The Shoulder Surgeon | Specialist keyhole surgery for the treatment of shoulder and elbow problems

The Shoulder Surgeon | Specialist keyhole surgery for the treatment of shoulder and elbow problems
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Common Shoulder Injuries

Shoulder Problems


Acromioclavicular joint stabilisation Protocol
(Lars Ligament, Button procedure, Weaver Dunn)

The protocols should be goal orientated focusing on what the patient can achieve with ease and good quality movement / technique. The times are a guideline to allow you assess the patient’s progress.

Please note that this is the protocol for the patients having different shoulder procedures.

I have to stress the fact that this protocol applies to most patients but not all. Please refer to operation notes for any special instructions. If there are no special instructions you may follow these protocols.

If for whatever reason you are concerned please do not hesitate to contact me. If you can’t contact me please contact a doctor, preferably from my team.

Thank you.


Day of Op
  • Axillary hygiene
  • Finger, wrist and elbow exercises
  • Teach how to remove sling and replace it safely (for exercises only) before discharge

Upto 3/52

  • Polysling Finger, wrist and elbow exercises
  • Posture correction / scapula setting
  • Active assisted closed chain movements up to 90° flex, 60° abd, full ER with arm fully supported
3 - 6/52
  • Progress active assisted exercises to active short lever to 90° flexion
  • Continue with active assistedabduction in the scapular plane to 60 degrees and supported ER
  • Isometric rotator cuff strengthening with the forearm supported
  • Postural correction and core stability whilst wearing sling
  • Wean off sling from 6/52
  • Active exercises through full ROM ( start short lever then progress to long lever /functional elevation)
  • Functional strengthening of Rotator cuff and deltoid strengthening exercises (starting short lever and progress as comfort and quality of movement allows)
  • Scapular stabilizing exercises
  • Proprioceptive retraining w/ some weight-bearing (eg 4 point kneeling over gym ball +/- alternate arm raises progress slowly increasing amount of weight bearing dependant on pain and quality of movement)


Note:  Avoid lifting anything heavy on the operated side for 6/12.