AC Joint Dislocation Reconstruction Recovery [Shoulder]

GENERAL GUIDELINES

Pain:
A nerve block may be used during the procedure, which means that immediately after the operation the shoulder and arm can feel numb for a few hours. The shoulder will be sore when this wears off and this may last for the first few weeks. It is important that you continue to take the painkillers. Ice packs may also help reduce pain. Wrap frozen peas/crushed ice in a damp, cold towel and place on the shoulder for up to 15 minutes.

Wearing a sling:
You will return from theatre wearing a sling with a body belt. It should be worn under your clothes for three weeks. Only very gentle movements will be allowed under the guidelines of your physiotherapist i.e. for hygiene. After three weeks the body belt will be removed and you will continue to wear the sling over the clothes for a further three weeks. At this time you will start formal physiotherapy.

The wound

  • Open repair: there is an incision of 5cms over the top of the shoulder. The stitch is dissolvable but may require trimming at 3 weeks. Keep the wound dry until it is well healed.
  • Arthroscopic (keyhole) repair: This keyhole operation usually done through five to six 4mm puncture wounds. There will be no stitches; only small sticking plaster strips over the wounds. These should be kept dry until healed. This usually takes 5 to 7 days.

If your wound changes in appearance, weeps fluid, pus, or you feel unwell with a high temperature, contact immediately your GP.

Posture
Before starting any activity/exercise it is important to position your shoulders correctly. This allows normal shoulder function. Gently move your shoulder blades down and in towards the spine but not in a braced back position.

Driving
You will not be able to drive for a minimum of 8 weeks. Your surgeon will confirm when you may begin.

Returning to work
This will depend upon your occupation. You will need to discuss this with your surgeon. Remember you will be completely one-handed for the first 6 weeks and all movements or activities above shoulder level should be avoided for at least 12 weeks from your operation.

Leisure activities
Your physiotherapist and surgeon will advise you when it is safe to resume your leisure activities.

Follow up appointments
You will be asked to make an appointment to be reviewed at The Shoulder Unit approximately three weeks after your procedure. You will be reviewed by your surgeon/specialist physiotherapist who will check your progress.

Progression
This is variable. Following discharge your pain will slowly decrease and you will become more confident. After 6 weeks your physiotherapist will guide you through an appropriate exercise program to help you regain full function.

Exercises
You will perform only elbow, wrist and hand exercises for the first 3 weeks.Your physiotherapist will teach you the following exercises.

  1. Keep your arm in the sling and move your hand up and down at the wrist.
  2. With your arm in the sling and the elbow bent at your side, turn the hand to face the ceiling and then the ground.
  3. With arm in the sling regularly shrug shoulders up and down and circle forwards and backwards
  4. In sitting, take your arm out of the sling, bend and straighten the elbow on to your lap.

Repeat each exercise 10 times hourly. Continue these exercises until otherwise advised by your physiotherapist.