Meet Our Physicians       Patient Education       Patient Registration       Post-Op Instructions       Special Precautions       Rehab Protocols       Links of Interest	Planning for Surgery Rehabilitation Protocol: ACROMIOPLASTY/MUMFORD PROCEDURE This program is designed as a guide for both the patient and therapist. Important variables with the surgical procedure include: Concomitant rotator cuff repair PREOPERATIVE PHYSICAL THERAPY Preoperative orientation visit, review protocol Instructions on placement of immobilizer/sling and proper icing techniques Instruction in home exercise program (fingers, wrist, elbow and pendulum) Instruction in future overhead pulley and scapular stabilizer exercises Schedule first outpatient physical therapy visit beginning 7-10 days after surgery Phase 1: Immediately post-op to 2 weeks Goals: To being movement of fingers, wrist and elbow. To decrease pain and swelling in the shoulder. To increase shoulder passive ROM. Improve shoulder function. Limitations: May not lift more than a coffee cup. Brace: For one week the sling/immobilizer should be worn at all times except for therapy and personal hygiene. May discontinue as tolerated after one week. Therapeutic exercises: Avoid impingement positions Passive shoulder internal and external rotation as tolerated Active ROM fingers, wrist and elbow Pendulum Begin active shoulder pinches (scapularº (abduction) Wand ROM - in supine position Rope and pulley exercise (being once 120º achieved with wand) Avoid shoulder adduction across body and shoulder extension Watch for signs of RSD Continue icing program Active forward flexion as tolerated (goal 0º to 90º by 2 weeks) Isometric forward flexion, extension, adduction, abduction, internal and external rotation (being once full passive ROM is achieved) Phase 2: past 2 weeks Goals: To improve active shoulder ROM, functional mobility, limit pain, and begin strengthening. Limitations: No lifting of heavy objects causing axial traction. May not lift more than 5lbs until pain free. Therapeutic exercises: Active forward flexion as tolerated Continue home program Continue wand ROM - in supine position Active ROM forward flexion as tolerated Active abduction in scapular plane Prone stretches (ER, forward flexion, abduction) Gravity eliminated internal/external rotation Begin wall walking for forward flexion Discourage scapular compensation with forward flexion and abduction Begin IR stretches Begin strengthening with rubber tubing/straps and light weights at 3-4 weeks Emphasize strengthening (scapular stabilizers, latissimus dorsi, trapezius) Emphasize rope and pulley system ***Notice*** Patient should be pain free for 3 weeks prior to returning to full sports activities.