PHYSICAL THERAPY PROTOCOL
Distal Clavicle Excision
Physical Therapy Protocol
Rehabilitation following arthroscopic distal clavicle excision focuses on restoring shoulder motion, reducing pain, improving scapular mechanics, and returning patients to unrestricted daily activities, work, and sports as symptoms allow.
Motion & Pain Control
Restore Function
Strengthening
Full Activity
Important Note
This protocol serves as a general guideline. Patients undergoing additional procedures such as rotator cuff repair, labral repair, or biceps tenodesis should follow the more restrictive rehabilitation protocol. The surgeon's postoperative instructions always take precedence.
Rehabilitation Philosophy
Unlike tendon or labral repairs, distal clavicle excision does not require prolonged biological protection. Motion is encouraged early, with progression based primarily on pain, swelling, and restoration of normal shoulder mechanics rather than tissue healing restrictions.
Phase I: Early Motion
Timeframe: 0–2 Weeks
Goals
- Control pain and swelling
- Restore passive and active shoulder motion
- Prevent stiffness
- Normalize scapular motion
- Return to light daily activities
Sling
- Sling for comfort only
- Discontinue as tolerated
- Remove frequently for exercises
- Encourage normal arm use within comfort limits
- No heavy lifting initially
Exercises
- Pendulum exercises
- Passive and active shoulder motion
- Table slides
- Wall walks
- Scapular retraction exercises
- Elbow, wrist, and hand motion
Phase II: Functional Motion
Timeframe: 2–6 Weeks
Goals
- Restore full range of motion
- Normalize shoulder mechanics
- Improve endurance
- Resume routine daily activities
Exercises
- Active range of motion
- Pulleys
- Posterior capsule stretching
- Scapular stabilization
- Light rotator cuff activation
- Closed-chain stabilization as tolerated
Phase III: Strengthening
Timeframe: 6–12 Weeks
Goals
- Restore normal strength
- Improve endurance
- Return to unrestricted activities
- Optimize scapular control
Exercises
- Theraband strengthening
- Progressive dumbbell strengthening
- Rotator cuff strengthening
- Deltoid strengthening
- Scapular strengthening
- Functional strengthening
Return To Activity Guidelines
Desk Work
Often within several days.
Driving
When comfortable and no longer taking narcotic pain medication.
Daily Activities
As tolerated, with gradual progression during the first several weeks.
Weight Training
Typically resumes between 6–8 weeks as pain allows.
Golf
Putting and chipping as comfort allows; full swing often around 6–8 weeks.
Contact Sports
Generally after restoration of full strength and pain-free function.
Therapist Notes
- Encourage early shoulder motion.
- Focus on restoring normal scapulothoracic mechanics.
- Progress strengthening based on symptoms rather than rigid timelines.
- Avoid prolonged immobilization.
- Notify the office if pain progressively worsens or recovery plateaus unexpectedly.
Red Flags
Contact The Office For
- Increasing redness
- Drainage from the incision
- Progressively worsening pain
- Loss of shoulder function
- Persistent swelling
Seek Urgent Care For
- Chest pain
- Shortness of breath
- Calf pain or swelling
- Severe uncontrolled pain
Related Resources
Questions About Distal Clavicle Excision Rehabilitation?
Early motion and restoration of normal shoulder mechanics are the keys to a successful recovery following distal clavicle excision. Most patients regain function quickly and return to normal activities with progressive rehabilitation.
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