Shoulder Problems

The most common cause of acromioclavicular joint arthritis is wear and tear through over use. For this reason it is most common in people who are aged 50 or older and in athletes who place a lot of stress on the joint.

Bicep Problems

The most common shoulder conditions affecting the biceps are injuries to the cartilage and tendons that attach the biceps muscle to the shoulder bones. These include SLAP lesions, tendonitis, and tendon rupture.

Calcific Tendonitis

Calcific tendonitis is a build-up of calcium deposits within one or more of the four tendons that meet at the top of the shoulder joint. Together these four tendons are known as the rotator cuff.

Frozen Shoulder

Frozen shoulder is a condition where the ball and socket joint of the shoulder appears to "freeze". This causes loss of motion with stiffness in all directions. Typically the shoulder joint is stiff and initially painful.

Shoulder Arthritis

Glenohumeral arthritis is also known as shoulder arthritis. It is a progressive type of arthritis that is normally caused by damage to the cartilage surfaces of the shoulder's glenohumeral (ball and socket) joint.

Shoulder Instability

This is when the ball of your shoulder slips in certain position or completely comes out of joint (dislocates). There are a number of types of instability and it can get worse with time.

Rotator Cuff Injuries

The rotator cuff is the group of four tendons that surround the shoulder joint and control its movement. The tendons can become inflamed, degenerate or tear and can lead to pain and weakness, particularly with sudden movements.

Snapping Scapula

Snapping scapula is a general term applied to a range of disorders that can result in a painful clicking or snapping sensation in the shoulder blade (scapula).

Subacromial Impingement

Subacromial impingement is a condition that causes pain in the shoulder and upper arm. It happens when the tendons of the shoulder joint are strained or injured.

Winging Scapula

Winging scapula is the description for a condition where the shoulder blade protrudes from your back, giving the impression of a wing. In most cases, only one shoulder blade is affected.

Subacromial decompression and ACJ excision

Arthroscopic Subacromial Decompression + Arthroscopic Excision of Distal Clavicle (ACJ resection)

On Ward

Wear sling as needed for rest and pain relief for approx. 2 days.

Avoid axial loading through upper limb.

Exercises and advice sheet given by physio i.e. active assisted exercises, GHJ – elevation and lateral rotation, posture, scapula setting and isometric cuff. No limitations in range of movement BUT active exercises dependant on pain limitation and muscle control of movement. – do not encourage full range into pain. Most patients remain below 90 degrees AROM in first 2-3 weeks.

Care of sling and washing techniques.

Removal of sling for gentle exercises advised 4 times/day.

May be limited by pain but can progress > 90° elevation after the first 2/52. No restrictions in ROM, dependant on active muscle control and pain.

2-6 weeks

Progress as subacromial decompression. Patients may be have more pain at end range elevation than standard ASAD so progress may be slower with longer rehabilitation time.

6 weeks +

Functional and sports specific rotator cuff and scapular training through range, to include proprioception.

Return to work: Sedentary 2-3 weeks (as pain allows). Physical 4-6 weeks (as pain allows).

Driving: 2 weeks (as pain and range allows) patient confirms they are able to drive safely.

Sport: Non contact 2-3 months. Contact 3-6months

Swimming: Gentle with modified stroke 3-4 weeks. Freestyle 8 weeks

Andrew Cole6 November 2018

Subacromial decompression and ACJ excision

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Southampton Shoulder Clinic

Southampton Shoulder Clinic

Mr Cole’s Shoulder Clinic