Post-surgical Physiotherapy Management for Acromioclavicular Joint Injuries

Abstract

Ideally, conservative management is employed for the grade I and grade II AC joint injuries. For grade III injury non non-operative compared to the surgical procedure is still questionable, as literature has shown that non-operative management has proven to be equally effective as the surgical procedures. Physical therapy may follow different post-operative regimens for Type V and VI injuries, which are thought to require surgical treatment.  There is no evidence-based literature that suggests a particular course of treatment for category IV and V injuries. Although surgery is the recommended course of action, manual reductions have been successfully used. Oedema control, restoration of the ranges, wound healing and early mobilization; are among the main objectives post surgery. ROM exercises are the first part of treatment, which subsequently progresses to strengthening. In order to prevent the development of chronic pain and instability in the AC joint, rehabilitation must be completed to the point of maximum strength and mobility. Restoration of scapular control to allow a safe return to sport and high-level activities is the cornerstone of therapy after acromioclavicular injuries. A sequence of steps including pain management, mobilization to enable sufficient muscle recruitment, periscapular muscle strengthening, and lastly, sport-specific workouts can be used to restore coordinated and effective scapular mobility.