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Exercise Protocol for Acromioplasty

Chronic shoulder pain is often caused by impingement syndrome, a pinched condition of the rotator cuff tendon. This condition is sometimes resolved by rest and therapy, but it might require surgical intervention in some patients. Open acromioplasty surgery is used to relieve subacromial impingement and, coupled with a proper recovery and exercise regimen, may return the patient to a pain-free lifestyle. Your doctor will prescribe a specific rehabilitation program based on your needs.

  1. Exercise Protocol 0--Four Weeks

    • In the first four weeks after surgery, clinical goals focus upon whatever active and passive range of movement the patient can tolerate as well as pain-free sleeping. You may perform normal daily activities to the shoulder height you can tolerate. Ice is used to control swelling and pain. Light (passive) movements assisted by a therapist or active range of movement is performed dependent upon your tolerance of pain. Exercises generally employ a pulley, pendulum and wand in the planes of motion that can be tolerated. Some isometric strengthening may also be started at this time. You will need to make weekly visits to measure your pain and range of motion.

    Exercise Protocol Four-12 Weeks

    • Weeks four through 12 focus on your ability to perform painless active range of motion and light work activities. You may be tested for bilateral strength and range of motion. Exercises include stretching in doorways for flexion and external rotations in order to attain end-range motions. Ice may be used as needed. You may begin tubing exercises during this period at 90 degrees of elevation in addition to dumbbells at an abduction level of 90 degrees. Hughston exercises---which involve a table and specified range of motion exercises for the arms---are incorporated for scapular stabilization, if it can be tolerated. Proper elevation techniques are emphasized in order to aid scapular stabilization. Isokinetics---exercises that challenge muscles against objects that increase in resistance---are discouraged by some physicians during this phase of healing.

    Exercise Protocol Three--Six Months

    • Clinical goals at this stage of recovery are for you to achieve pain-free work and athletic activities, with the hope of returning you to your presurgery level of activity. Bilateral range of motion is tested. You may be able to use heavier weights for exercise in addition to incorporating weight room exercises such as lateral frontal pulls, bench press, rows and bicep and tricep exercises. Strengthening work at or above 90 degrees may be incorporated if you remain pain-free while performing it. Behind-the-neck exercises, such as flys, shoulder presses and lateral pulls to the back, are discouraged. You will be discharged from the program once you are able to achieve normal strength and resumption of full pain-free activity and range of motion.

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