ARTHROSCOPIC DEBRIDEMENT/
AND/OR SUBACROMIAL DECOMPRESSION PROTOCOL
This rehabilitation program is designed to return the athlete/patient to full function as quickly as possible. Progression is dependent upon response of the patient. Some people are able to progress more quickly than others. Patient symptoms, pain, swelling, and ROM will dictate progression.
* Subacromial Decompressions may move 1 – 2 weeks more slowly through the protocol than a debridement. Progress as symptoms allow
Phase I – Immediate Motion Phase
Goals:
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Reduce pain and inflammation
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Prevent negative effects of immobilization
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Re-establish full, non-painful range of motion
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Prevent muscular atrophy
Week 1-2 (Day 1-14)
Flexibility exercises:
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Pendulum exercises
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Shoulder shrugs/squeezes, elbow, forearm, wrist ROM
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Wand exercises: flexion, scaption, ER/IR (start close to body, work to 45 degrees abduction, extension)
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Towel or wand IR
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Pulley flexion, scaption
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Capsular mobilization – grade 1-3 - concentrate on increasing post capsular mobility
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PROM
Strengthening exercises:
Week 1:
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Gripping
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Shoulder isometrics – 6 way with towel between arm and body, week 2 progress to multi angle
Week 2:
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Scapular PNF with manual resistance
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Rhythmic stabilization drills in supported, scapular plane position, and in 90 degrees of flexion
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Prone scapular exercises – start with row and extension. If doing well can progress to horizontal abduction and flex at 105 as tolerated.
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Sidely ER
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Standing ER/IR with theraband with towel between arm and body
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Supine flexion and D2 exercises – start with no weight, and progress by 1# at a time
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Bicep/tricep/forearm/wrist with theraband or weight
Modalities:
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Ice, EGS
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Instruct in use of home ice, support positions (pillow between arm and body, correct sleeping positions with pillow under arm and between arm and body)
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