AC Joint Reconstruction Starter Exercise Guide

1. Pendulum Swings

What it helps: Coaxes the shoulder through gentle motion with the muscles relaxed — keeping the joint moving and easing stiffness when active movement is still uncomfortable.

How often: 2–3 sets of 1–2 min, a few times a day.

1. Lean forward and support your good arm on a table or chair, letting the sore arm hang down relaxed.
2. Let the arm swing gently — small circles, then forward-and-back and side-to-side — using a gentle sway of your body, not the shoulder muscles.
3. Keep it loose and pain-free, like a relaxed pendulum.

Tip: The movement comes from rocking your body, not from working the shoulder.

2. Cane-Assisted Shoulder Flexion

What it helps: Keeps the shoulder moving while the repaired tendon is protected from doing any work. Movement in these early weeks is what prevents the stiffness that is otherwise the hardest part of the recovery to undo.

How often: 2–3 sets of 10–15, daily.

1. Lie on your back holding a broom handle, walking stick or length of dowel across your body with both hands, palms up.
2. Keep the operated arm completely relaxed — let it be carried.
3. Use the good arm to push the stick, raising both arms up over your chest and toward your head.
4. Go only as far as is comfortable and as far as your surgeon has allowed, then lower slowly using the good arm to control it.

Tip: The operated arm is a passenger. If its muscles are working, the exercise is not doing its job.

3. Cane-Assisted External Rotation

What it helps: Preserves the outward rotation of the shoulder, which is the movement most commonly lost after a rotator cuff repair and the hardest to regain once it has gone. Doing it passively means the repair is not loaded.

How often: 2–3 sets of 10–15, daily.

1. Lie on your back or sit with the operated elbow tucked against your side, bent to a right angle. A rolled towel between elbow and body helps.
2. Hold a stick across your body with both hands.
3. Keeping the elbow against your side, use the good arm to push the stick so the operated forearm rotates outward, away from your stomach.
4. Go only to the limit your surgeon has set, hold briefly, then let the good arm bring it back.

Tip: The elbow stays glued to your side. Letting it drift away from the body turns this into a different, less useful movement.

4. Elbow Range of Motion

What it helps: Keeps the elbow and forearm moving through their full range — preserving the bend, straighten, and rotation you use for everyday tasks.

How often: 2–3 sets of 10 each, daily.

1. Bend the elbow to bring your hand toward your shoulder, then slowly straighten it all the way.
2. With the elbow tucked at your side and bent 90°, turn your palm up, then down.
3. Move smoothly through comfortable range; don't force the ends.

Tip: Keep the upper arm still — the movement is at the elbow and forearm.

5. Grip Strengthening

What it helps: Builds the grip and forearm strength behind almost every hand task — and supports the tendons at the elbow that grip relies on.

How often: 2–3 sets of 10–15, most days.

1. Hold a soft ball or therapy putty in your hand.
2. Squeeze firmly and hold a few seconds, then relax fully.
3. Work through comfortable effort; stop short of sharp pain.

Tip: Full squeeze, full relax — both matter.

6. Scapular Retraction

What it helps: Keeps the muscles that position the shoulder blade working while the shoulder joint itself is resting. Those muscles set the platform the whole shoulder moves on, and they weaken quickly in a sling, which makes the later recovery harder than it needs to be.

How often: 2–3 sets of hold 5s, 10 times, daily.

1. Sit or stand tall with your arms resting at your sides or supported in the sling.
2. Draw both shoulder blades gently back and down, as though squeezing them toward each other.
3. Keep the movement small and slow. Your arms should not move at all.
4. Hold briefly, then relax completely.

Tip: Small is correct. This is a squeeze between the shoulder blades, not a shrug and not an arm movement.

7. Gentle Neck Isometrics

What it helps: Strengthens the deep muscles that support and steady your neck without moving it — a safe, comfortable way to build the support that eases neck pain.

How often: 5 each direction sets of Hold 5–10 seconds, daily.

1. Sit tall with a gentle chin-tuck. Place your palm on your forehead.
2. Press your head lightly into your hand and your hand back into your head — a steady, comfortable push with NO movement of the neck.
3. Hold, relax, and repeat. Do the same with the hand on the back of the head, then each side.

Tip: Light pressure — about 20–30% effort. This is not a strength test.

8. Upper Trap & Levator Stretch

What it helps: Loosens the tight neck-to-shoulder muscles that often build up tension and pull on the neck, easing stiffness and discomfort.

How often: 2–3 each side sets of Hold 20–30 seconds, daily.

1. Sit or stand tall. Gently tip one ear toward that shoulder until you feel a comfortable stretch along the opposite side of the neck.
2. For the levator (back-corner of the neck), turn your nose toward your armpit and ease forward a little.
3. Rest the hand on that side gently behind your head for a touch more stretch — no pulling. Switch sides.

Tip: Gentle and comfortable — never force the neck.

Recovery reading

• ACL Surgery Recovery
• Meniscus Surgery Recovery
• Recovery After Knee Arthroscopy
• Rotator Cuff Surgery Recovery
• All Sports Medicine recovery guides