Sports Medicine and Shoulder Surgery 
PHYSICAL THERAPY PRESCRIPTION:  
 
AC JOINT AND CORACO-CLAVICULAR (CC) LIGAMENT RECONSTRUCTION 
WITH ALLOGRAFT or AUTOGRAFT TENDON 
 
Weeks 0-6: Post Operative Phase (HEP) 
Sling Immobilizer: At all times except for showering and exercise 
Exercises: 
NO shoulder ROM 
 
 
AROM wrist/elbow  
 
 
Scapular “pinches”  
 
 
Weeks 6-8: Phase I (HEP) Start with physical therapist for your program at week 6. 
Sling Immobilizer: At all times except for showering and exercise 
Exercises: 
Passive supine ER to neutral and extension to neutral 
 
 
Passive supine FF in scapular plane to 100 
 
 
AROM wrist/elbow  
 
 
Scapular “pinches”  
 
 
Pain free submaximal deltoid isometrics in neutral position 
 
 
 
 
Weeks 8-11: Phase II  
Sling Immobilizer: At all times except for showering and exercise 
           Discontinue at week 9 
Exercises:  
Passive & Active assisted FF in scapular plane – limit 140 (wand exercises, no pulleys)  
 
 
Passive & Active assisted ER – no limits (go SLOW with ER) 
    
 
Manual scapular side-lying stabilization exercises 
 
 
IR/ER submaximal, pain free isometrics 
 
2 
 
 
Modalities as needed 
 
Advancement Criteria: FF to 140 
 
 
 
 ER to 40 
 
 
 
 Minimal pain and inflammation 
 
 
Weeks 11-15: Phase III 
Exercises:  
 AAROM for full FF and ER 
 
     
AAROM for IR – no limits 
 
 
IR/ER/FF isotonic strengthening (start when full range) 
 
 
Scapular and latissimus strengthening  
 
 
Humeral head stabilization exercises 
 
 
Begin biceps strengthing 
 
 
Progress IR/ER to 90/90 position if required 
 
 
General upper extremity flexibility exercises 
 
 
Advancement Criteria: Normal scapulohumeral rhythm 
 Full upper extremity ROM 
 Isotonic IR/ER strength 85% of uninvolved side 
             Minimal pain and inflamation   
 
 
Weeks 15-18: Phase IV 
Exercises:  
Continue full upper extremity strengthening program 
 
 
Continue upper extremity flexibility exercises  
 
 
Activity-specific plyometrics program 
 
 
Begin sport or activity related program 
 
 
Address trunk and lower extremity demands 
 
Begin Throwing program at week 18 if overhead athlete  
• Begin light tennis ball tossing at 20-30ft. max at 60% velocity, work on mechanics of 
wind up, early cocking phase, late cocking phase, acceleration, and follow through 
• Isokinetics at high speeds – with throwing wand if thrower, 240, 270, 300, 330, 
360°/sec and up, 15 reps each speed  
• Throwers begin re-entry throwing program on level surface (criteria to start program 
listed on re-entry throwing protocol) 
• Continue strengthening and stretching programs 
§ Emphasize posterior capsule stretching  
 
 
 
 
Discharge Criteria: Isokinetic IR/ER strength equal to uninvolved side 
          Independent HEP 
       
   
          Independent, pain-free sport or activity specific program   
 
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