AC Joint Reconstruction Physical Therapy Protocol

Phase 1: Protection and Range of Motion (Weeks 0–4)

• Sling Usage: Sling with abduction pillow (discontinue pillow at Week 4).
• Restrictions:
  • No active range of motion (AROM) until Week 8.
• Exercises:
  • Pendulums.
  • Scapular retractions (avoid shoulder shrugs).
  • Active elbow, wrist, and hand range of motion (ROM).
  • Passive range of motion (PROM):
    • Shoulder flexion and abduction to 90 degrees.
    • External rotation (ER) and internal rotation (IR) unrestricted.

Phase 2: Early Strengthening (Weeks 4–6)

• Key Changes:
  • Discontinue abduction pillow.
• Exercises:
  • Begin isometrics for ER and IR.
  • Assisted active range of motion (AAROM):
    • Flexion and abduction to 90 degrees.
    • Full ER and IR.

Phase 3: Strength and Mobility (Weeks 6–8)

• Key Changes:
  • Discontinue sling.
  • Progress to full AAROM as tolerated.
• Exercises:
  • Unrestricted isometrics for rotator cuff (RTC) and periscapular muscles.
  • Begin concentric and eccentric exercises at Week 8.

Advanced Sports-Specific Training (Week 16 Onwards)

• Key Focus:
  • Advanced weight-bearing exercises.
  • Plyometric exercises.
  • Sports-specific drills.