ASD/ACJ Excision

ASD and/or ACJ Excision


  • Evidence of inflammation or scuffing on the under surface of the acromion, coracoacromial ligament & on the bursal side of the rotator cuff (i.e. presence of impingement


  • Removal of bone from the acromion & partial resection of the coracoacromial ligament
  • The AC joint remains intact unless excision is indicated, the distal clavicle and part of the acromion is removed
  • The superior AC ligament remains intact so that the joint remains stable


  Post op
On Discharge from Hospital 


  • Immobiliser (This should be removed within the first 2-3 days
  • Post-op Exercises on discharge 
  • Active (assisted) glenohumeral movement in all planes
  • Teach postural awareness and scapular setting

Out patient Physio

Levels 1-3 Exercises

Levels 1-3 Exercises


Levels 1-3 Exercises

  • Begin isometric strengthening (progress using pain & ROM as the limiting factor)
  • Rotator cuff strengthening
  • Address posterior capsular tightness (sleeper stretch and cross-shest adduction)
  • Over zealous physio or repetitive sustained overhead activity could lead to delayed healing & pain



Full recovery can take 6-9 months.
Expect 80% improvement by 3 months.



Any significant increase in pain or decrease in ROM arrange a clinic appointment for a review. 

See Post-Operative Exercises

 Return to functional activities

Return to work            Sedentary job: as tolerated

                                    Manual job:      may need to modify activities for 3 months

 Driving                        1 week

Swimming                   Breaststroke:   as able

                                    Freestyle:          12 weeks

Golf                             6 weeks

Lifting                         as able

Racquet sports            Avoid repetitive overhead shots for 3 months


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