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


ASD and/or ACJ Excision Protocol

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.


Post op

Day 1

Polysling overnight, for comfort only, remove after 1-2 days        

Finger, wrist and elbow movements

Active glenohumeral movement in all planes focusing on

good quality humeral scapular rhythm with minimal pain

Teach postural awareness and scapular setting

1 – 6/52

Progress ROM in all direction ensuring good quality of movement.

Progressive strengthening through ROM available (minimal pain and work on facilitation of posterior cuff)

Activity / functional specific exercises

6/52 +
Continue therapy, consider soft tissue restrictions to ROM and use manual therapy if required to increase ROM


NB: Please explain to patients that the full benefit of the operation may be after 9 months. Till then the patients would be expected to improve steadily

Warning: Over zealous physiotherapy or repetitive overhead, sustained exercises can aggravate shoulder; monitor the level of pain experienced.

Milestones:   By 6/52 patient should have 80% pre-op ROM