Distal Clavicle Excision

Shoulder
Written By

Download this rehabilitation protocol (PDF)

For patients and physiotherapists.

Week 0-1

Aims:

  • Pain control
  • Allow the wounds to heal
  • Maintain overall mobility
  • Axilla/armpit hygiene

Suggested treatment:

  • Ice
  • Regular pain relief
  • Elbow/wrist/hand and neck ROM exercises
  • Sling most of the time, off for hygiene

Week 1-4

Aims:

  • Wean out of sling
  • Minimal pain
  • Regain AROM
  • Wound check around 2wks

Suggested treatment:

  • PROM à AAROM/AROM
  • Wean out of sling

Week 4 and beyond

Aims:

  • Minimal pain
  • Increased active ROM

Suggested treatment:

  • Continue with AROM
  • Strengthening including cuff

Restrictions:

  • No heavy lifting

Week 8 and beyond

Aims:

  • Improve endurance/power of operated shoulder

Suggested treatment:

  • Heavy lifting allowed
  • No other restrictions

Some General Questions

What to expect after surgery:

  • Most patients will stay a night post operatively
  • After you wake up, you may notice your whole arm feels numb from the local anaesthetic applied to the nerves of your arm – this should wear off approximately 12 hours after surgery
  • The next morning, you will be seen by the medical team and physiotherapists prior to your discharge
  • You will be sent home with medications or a script to help with pain relief

Time in Sling:

  • Generally your sling should be on at all times (except for hygiene) in the first 1-2 weeks
  • From 2-4 weeks, you can wean out of the sling gradually using it less and less each day. You do not need to use your sling at night/sleeping
  • From 4 weeks, you should not need to use your sling at all

Return to Activity

  • Driving: when adequate range of motion and pain to allow safe control of the car and to react appropriately in an emergency. Both arms must be fully functional and on the wheel for this to occur. Usually dependent on time in sling.
    Return to driving from 4 to 6 weeks post op
  • Work: desk based roles should be able to return once pain has settled – usually approximately 2 weeks after surgery. Those with more manual occupations may need specific recommendations and light duties are usually recommended
  • Swimming: water based exercise is very helpful after surgery. No swimming until the wounds have healed – usually 2 weeks post operatively. Breaststroke by 4 weeks and freestyle by 8 weeks.
  • Golf: usually requires significant rehab and time. Usually 2-3 months post op
  • High Risk Sports (eg racquet sports, rock climbing, football, martial arts, skiing, horse riding). These sports are dependent on ROM, control and strength. Improvement in shoulder strength can be seen up to 2 years post operatively. Strength training/heavy lifting can commence from 8 weeks
    Contact sports or those at risk of falls (skiing, horse riding) shouldn’t occur till 2-3 months post op

Concerns or questions?

If you have any concerns post operatively, or you would like further information, please contact Mr Lau through the VBJS on 03 5752 5020 or via email at admin@vbjs.com.au

If you need urgent medical help, call 000 or go to your nearest emergency department.

These notes have been prepared by Mr Simon Lau. They are general overviews and information aimed for use by his patients. They reflect Mr Lau’s views, opinions and recommendations. They do not constitute medical advice. The contents are provided for information and education purposes only. Please seek Mr Lau’s specific advice with any questions regarding medical conditions and treatment.

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