Subacromial Decompression and/or Excision of the Distal Clavicle. Stage 1 – Physiotherapy Advice and Exercise.

This leaflet informs you about stage one post-operative exercises and advice following subacromial decompression and/or excision of the distal clavicle.

Before you are discharged, a member of the inpatient therapy team will guide you through the exercises. They will provide you with advice and answer any questions you may have.

You will then be contacted by the outpatient physiotherapy team, who will provide you with advice and exercises to aid in your recovery.

For how long should I wear my sling?

The sling provided is used for comfort and should be discarded once the nerve block has fully worn off. Do not remove the sling until you have full feeling back in your arm.

This usually takes between 12 to 48 hours.

Once you have removed the sling, you can use your shoulder as normally as comfort allows and start your exercises as shown.

What can I do to help myself?

It is very important to get as much movement back in your shoulder as soon as you can. This will mean you can start to use your shoulder normally and perform your daily functions.

Managing your pain and doing your exercises every day will help this to happen quicker. If you require it, pain relief can be very useful to help minimise any pain and give you the confidence to exercise and use your shoulder.

If you have been given pain relief, you should take as prescribed.

You should always read the label if using over-the-counter medication and, if you are in any doubt, speak to your pharmacist or GP.

If your pain becomes severe or is continuous, you should contact your GP.

What exercises should I do following my surgery?

You should aim to perform the following exercises 3 times a day. Perform 10 repetitions, have a rest for 1 minute and repeat a further 10 times.

It is normal for you to feel aching, discomfort or stretching feelings when doing these exercises. If you experience intense and lasting pain (e.g. longer than 30 minutes) do the exercises less forcefully or less often. If this does not help, discuss the problem with the Physiotherapist.

Exercise 1: Seated table slides

While sitting, rest your hands on a table. Using a duster or similar object, lean forwards and slide your hands away from your body to as far as comfortable and then return to the start position.

Shoulder flexion:

Two examples have been provided. Try both exercises and find the one that is most comfortable for you and perform that one.

Exercise 2a: Shoulder flexion

Lying on your back, knees bent and feet flat. Head support if needed.

Hold a stick or similar object with hands at shoulder-width apart. Starting with the stick resting on your thighs, lift the stick with straight arms. Return to the start position.

Note: If you are unable to lay flat, you can perform the exercises while sitting, high lying with pillows for support or while standing. Find which position is most comfortable for you.

Exercise 2b: Shoulder flexion

Stand in front of a high table, place both hands on top of the table. Walk backwards away from the table, as far as you are comfortably able to. Leave your hands supported on the table, allowing your shoulders to flex. Walk forwards, returning to the start position.

Exercise 3: Shoulder external rotation

While sitting with your elbow supported on a table like in the image above, hold a stick or similar object. Use your unaffected arm to push the stick outwards to rotate your operated arm as far as you can and return to the start position.

Exercise 4: Shoulder abduction

Lying on your back, knees bent and feet flat. Head support if needed.

Hold a stick or similar object with hands at shoulder width apart. With the unaffected arm push the stick moving the operative arm away from the body in a diagonal movement up and out to the side. Return to the start position. Note: If you are unable to lay flat you can perform these exercises in sitting, high lying with pillows for support or standing.

Contact numbers

Upper Limb Secretary
Monday to Friday 9:00am to 5:00pm
Telephone: 01642 624442

Physiotherapy Appointment Queries
Monday to Friday 9:00am to 5:00pm
Telephone: 01429 522471

Ward32/33
24 hours a day, 7 days a week
Telephone: 01642 382832 / 01642 382732

Leven Unit
Monday to Thursday, 7.00 am to 8.00 pm
Fridays, 7.00am to 7.00pm
Telephone: 01642 383832

Other useful links

North Tees and Hartlepool NHS Foundation Trust – https://www.nth.nhs.uk/

Upper Limb (Shoulder, elbow, hand and wrist surgery) – patient information.
https://www.nth.nhs.uk/services/trauma-orthopaedics/upper-limb/

References

Edwards, P.K., Ebert, J.R., Littlewood, C., Ackland, T. and Wang, A. (2017). A Systematic Review of Electromyography Studies in Normal Shoulders to Inform Postoperative Rehabilitation Following Rotator Cuff Repair. Journal of Orthopaedic & Sports Physical Therapy

Pictures supplied by Physiotec. Accessible at: https://physiotec.ca/ca/en/

Patient Experience Team (PET)

North Tees and Hartlepool NHS Foundation Trust would like your feedback. If you would like to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Team who will help you to do this.

This service is based at the University Hospital of North Tees but also covers the University Hospital of Hartlepool, our community hospitals and community health services.

North Tees and Hartlepool NHS Foundation Trust

Telephone: 01642 624719

Freephone: 0800 092 0084

Opening hours: Monday to Friday, 9:30am to 4:00pm

Email: [email protected]

Out of hours

Out of hours if you wish to speak to a senior member of Trust staff, please contact the hospital switchboard who will bleep the appropriate person.

Telephone: 01642 617617

Leaflet Reference: PI078 version 1
Date for review: 02 June 2029