Rehab Protocol: AC joint & Coracoclavicular Ligament Reconstruction

First 2 weeks

• Reduce pain and inflammation:
  • Use your pain killers +/- anti-inflammatory medication as prescribed.
  • Ice packs can be applied during the first few days for 15-20 minutes at a time.
  • You may be more comfortable sleeping in a slightly inclined position, such as a recliner.
• Protect the surgical scar:
  • The surgical scar needs to be protected for 2 weeks. Keep your dressing as dry as possible and only have the dressing changed by a nurse or doctor if it becomes completely soiled from the scar itself or accidentally soaked by water. To reduce the chances of getting a wound infection, it will be best to keep the original dressing on until your 2-week follow-up visit.
  • Please contact Dr Grey if you have concerns regarding the dressing, or if you develop worsening pain and/or redness around the dressing.
• The sling:
  • Keep the arm in the sling for 6 weeks. You also need to sleep with the sling on. The sling should be opened a few times per day to allow the elbow to straighten. It can be removed when changing clothes or going for a shower, but try to keep the operated shoulder relaxed. Do not try to lift up your arm up by yourself yet. To wash your armpit, bend forward while keeping your arm and shoulder relaxed. Gravity will cause your arm to go away from your body, allowing easy access to your armpit.
• Exercises:
  • Commence hand, wrist and elbow exercises.
  • Gentle scapular setting exercises (squeezing shoulder blades together)

2 – 6 weeks

• The first post-operative visit is at 2 weeks. The dressing will be removed and the scar inspected.
• Continue with the sling
• Start pendulum exercises: Bend forward and allow the arm to hang down completely relaxed. Gently move it forwards and backwards, side to side, and make circular movements with the arm.
• Commence physiotherapy: Physio guidelines:
  • Gentle passive range of motion limiting forward elevation to 90’ and abduction to 60’
  • Active assisted range of motion limiting forward elevation to 90’ and abduction to 60’
  • Scapular setting exercises
• Avoid lifting anything heavy and pushing yourself up with the operated arm.
• The next post-op visit is at 6 weeks.

After 6 weeks

• The sling can be weaned
• Continue physiotherapy and stretching exercises.
• Progress to the active range of motion (lifting your arm without assistance)
• You can start driving at around 6 – 8 weeks, as long as you feel in control of the car.
• Start gradual resistance exercises at 10 weeks
• Manual labourers can restart manual labour at 4-6 months
• Contact sportsmen can return to full contact at 6 months.