Arthroscopic Decompression

The Day Of Surgery

1. I see you pre-operation and check consent and mark the site we will operate on
2. Later that day if your block is working and you are pain free you will be discharged
3. Clean waterproof dressings are placed prior to discharge
4. Post operative wound check appointment will be organised
5. You are given as required

Post Operative Physiotherapy Protocol
ACC 18 / Off Work certificate
ACC41 / Physio referral

1st week post Operation

• Wear your sling while the Block is working for the first 3-4 days
• As soon as you can use your arm below shoulder height do so
• You can perform Pendular exercises twice a  day if you comfortable until the wound check appointment

Wound Check

• 7-14 days post surgery the stitches will be removed by my practice nurse
• The waterproof dressings placed when you were discharged should last till this appointment
• Formal Physiotherapy can begin following this

6-8 week visit

• Your range of motion should have returned to near normal
• Strengthening is now the key to full recovery

3-4 months visit

• Most people have recovered by now and can be discharged
• Some patients need a few more months and another follow up visit is arranged

Arthroscopic Sub-Acromial Decompression Sub-Acromial Decompression

Rehabilitation Protocol

Day 1

• Cryocuff on ward
• Analgesia rest in sling
• Elbow, wrist and hand exercises

Day 2- 4

• Discharge with advice / physio referral sling for comfort 2- 4 weeks does not need to be worn at night unless patient has a lot of pain
• Commence ROM phase I-II regular analgesia for pain
• Avoid abduction for 4 weeks neck and thoracic mobility exercises
• Scapula control / awareness

2 weeks

• Clinic appointment wound check and stitch removal
• Check performing phase I – II exercises / continue analgesia
• Ice at home
• Re-assure: re pain and recovery and timescale

4 – 8 weeks

• Gradually progress exercise program
• Start phase III in neutral

3 – 4 months

• Gradual increase in strength through full range of activities

6 months

• Back to sport if appropriate
  
  
• If individual is doing well at an early stage , they may progress to strengthening through range before 3 months. Always check for good pattern of cuff and scapula dissociation. Warn some patients that they may be slower if poor pain resolution and this is part of normal spectrum
  
  
• Beware the post-op frozen shoulder and monitor at approximately 6 week intervals. Recommence strengthening and mobilising when in thawing phase