Mumford procedure rehab protocol
- Do not elevate surgical arm above 70° in any plane for the first 4 weeks post-op
- Do not lift any objects over 5 pounds with the surgical arm for the first 6 weeks
- Avoid excessive reaching and external/internal rotation for the first 6 weeks
- Ice shoulder 3 - 5 times (15 minutes each time) per day to control swelling and inflammation
- An arm sling is used for 4 weeks post-op
- Maintain good upright shoulder girdle posture at all times and especially during sling use
- MD follow-up visits at Day 1, Day 14 with nurse for suture removal, Month 1, Month 3, and Year 1 Post-op
Week 1:
- MD visit Day 1 post-op to change dressing and review home program
- Postural education
- Exercises (3 times per day):
- Pendulum exercises
- Squeeze ball
- Triceps and biceps training with Theraband
- Isometric rotator cuff external and internal rotations with arm at side
- Isometric shoulder abduction, adduction, extension and flexion with arm at side
Weeks 2 – 4:
- Clinic visit at 14 days post-op for suture removal and check-up
- Use of strapping tape for secondary AC compression and support (optional)
- Soft tissue treatment for associated shoulder and neck musculature for comfort
- PNF for elbow and wrist flexion and extension, scapular isometrics with manual resistance
- Add well-body exercises, maintaining protection of AC joint (i.e. squats, lunges, step-ups, bridging, opposite arm rotator cuff exercises, biking)
Weeks 4 – 8:
- MD visit at Week 4 post-op and will usually be progressed to a more aggressive ROM and strength program
- At Week 4: Start mid-range of motion (ROM) rotator cuff external and internal rotations active and light resistance exercises (through 75% of ROM as patient’s symptoms permit) without shoulder elevation and avoiding extreme end ROM
- Strive for progressive gains to 90º of shoulder flexion and abduction
Weeks 8 – 12:
- Seek gentle full shoulder ROM in all planes--especially with flexion, abduction, external rotation and internal rotation
- Increase manual mobilizations of soft tissue as well as glenohumeral and scapulothoracic joints for ROM
- Exercises: Wand exercises, ROM shoulder pulleys, scapular training (rows, protractions, lower trapezius work, etc), PNF
- No overhead lifting
Week 12 and beyond:
- Start a more aggressive rotator cuff program as tolerated
- Start progressive resistance exercises with weights as tolerated
- Continue to seek full shoulder range of motion in all planes
- Increase the intensity of strength and functional training for gradual return to activities and sports
- Return to specific sports is determined by the physical therapist through functional testing specific to the sport
NOTE: All progressions are approximations and should be used as a guideline only. Progression will be based on individual patient presentation, which is assessed throughout the treatment process.