Manipulation Under Anaesthetic Rehabilitation Protocol

Restrictions:

    • Sling for comfort only

Patients should have a grasp of exercises and use of sling and simple ADL functions prior to discharge home

Aim to get early control of shoulder girdle and interscapular muscles

Light pendular and rotation exercises with no range of motion limits

Instruction on maintenance of range of motion early within pain limitations

Circulation exercises

Do exercises 6 x per day

Aim for a relaxed exercises to avoid tension about the shoulder and neck

 

At 2 and 6 week follow up

Check pain levels

Observe simple ADLs

Range of motion in flexion, abduction and rotation should be measured

Check control of shoulder girdle and interscapular muscles

 

From 2 weeks postoperatively onwards

Goals

Increase range of motion (free range of motion within pain limits), scapulohumeral rhythm control, gradual increased activation of shoulder girdle musculature

Action

  • Passive and active assisted scapular range of motion exercises for flexion, abduction, internal and external rotation – focus on good quality motion

  • Scapular mobility exercises

  • Begin light isometric rotator cuff strength with flexed elbow.

  • Active theraband exercises from week 4 - 6: check for good scapulohumeral rhythm

  • Can gradually incorporate increase In isometric loading and concentric rotator cuff exercises

  • Aim for full range of motion by week

 

From week 6 onwards

Goals

Return to work and normalise ADLs and work practices

Action

  • Aim for normal active and passive range of motion

  • Functional training

  • ADLs, work and sports specific training

  • Increase muscle strength, power and stamina

  • Maintain full range of motion

 

Criteria for return to sport

Full range of motion. No pain with activity. Good muscular control.

Strength test 90% compared to uninjured side. 95% for contact and throwing

Constant score > 90% compared to uninjured side