This protocol is applicable to patients treated surgically for acromioclavicular joint separations.

Acj Separation Primary Repair

0-4 weeks: Arm in a sling. Sling may be removed to perform exercises, and for bathing, dressing and at meal times. Perform pendular exercises as well as exercises for the hand, wrist and elbow to maintain mobility. Encourage early external rotation stretching with the arm in adduction and perform assisted elevation in flexion to 90 degrees using table slides. After 2 weeks increase external rotation stretching to 40 degrees. Perform scapular retraction exercises. Patients in sedentary occupations may return to work and resume driving within 7-10 days. 

5-8 weeks: Discard sling. Restore normal glenohumeral and scapulothoracic motion and function with active-assisted ROM exercises including overhead elevation. Perform scapular exercises. 

9-12 weeks: Start rotator cuff strengthening with theraband and continue with ROM stretches. Avoid free weights. 

>12 weeks: May lift and carry objects as tolerated. Start sports specific training if indicated. Patients in manual occupations may return to work in a phased manner at this stage.