Arthroscopic Posterior Stabilisation

Indications:

Protocol

Post op

Day 1 - 3 weeks

Level 1 Exercises

  • External Rotation brace for 3 weeks (can remove for washing and exercise; wear on outside of clothes).
  • Teach axillary hygiene
  • Teach postural awareness and scapular setting
  • Active assisted ROM as comfortable (use 'safe zone' as guide)
  • Core stabiliity exercises with sling (as appropriate)
  • No combined forward flexion and Internal rotation exercises
  • Do not force or stretch

3 -6 Weeks

Level 2-3 Exercises

  • Wean off sling
  • Progress Active assisted to Active ROM as comfortable
  • Commence proprioceptive exercises (minimal weightbearing below 90 degrees)
  • No combined forward flexion and Internal rotation exercises
  • Do not force or stretch
6 - 12 Weeks

Progress to Level 3+ Exercises

  • The sling is removed by 6 weeks
  • Regain scapula & glenohumeral stability working for shoulder joint control rather than range
  • Gradually increase ROM
  • Strengthen - sports specific
  • Increase proprioception through open & closed chain exercise
  • Progress core stability exercises
  • Incorporate plyometrics and pertubation training
  • After 2 months any residual tightness to internal rotation may be addressed by specific stretching exercises

 

Milestones

Week 6

Active elevation to pre op level

Week 12

Minimum 80% range of internal rotation compared to asymptomatic side
Normal movement patterns throughout range

Failure to achieve milestones

Referral to shoulder clinic

 


See Post-Operative Exercises

 

 

Return to functional activities (guide to commence activity)
Return to work

Sedentary job: as tolerated 
Manual job: at least 3 months

Driving approx. 6-8 weeks
Swimming

Breaststroke: from 6 weeks 
Freestyle: 12 weeks

Golf can start from 3-6 Months
Lifting Light lifting can begin at 3 weeks. 
Avoid lifting heavy items for 3 months.
Contact Sport E.g. Horse riding, football, martial arts, racket sports and rock climbing: after 3 months

 

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