Arthroscopic Capsular Release (MUA) Rehabilitation Guidelines

Arthroscopic Capsular Release (MUA) Rehabilitation Guidelines

These rehabilitation guidelines provide a structured framework for recovery following arthroscopic capsular release (MUA). The program is tailored to each patient's needs and postoperative instructions, focusing on soft-tissue healing, restoring range of motion, and progressing to strengthening exercises.

Phases of Rehabilitation

Phase 1: 1–14 Days (Immediate Post-Surgery)

Goals:

1. Pain and Inflammation Management:
   • Use analgesics, NSAIDs, ice, and maintain proper posture.
2. Teach Shoulder Control:
   • Focus on scapular retraction and depression.
3. Regain Initial ROM:
   • Perform pendulum exercises with good scapulohumeral rhythm (SHR).
   • Begin ER/IR PROM and progress to AROM with good SHR.
4. Prevent Muscle Atrophy:
   • Introduce sub-maximal isometrics (<30% maximal voluntary contraction) in a pain-free range.
5. Maintain Adjacent Joint Mobility:
   • Exercise the hand, wrist, elbow, and neck as required.
6. Sleeping Position:
   • Support the shoulder appropriately to avoid discomfort or extension.

Precautions:

• Use a sling for 1–2 days for comfort.
• Keep wounds clean and dry.

Milestones:

• Pain and inflammation well managed.
• Return to pre-operative sleep patterns.
• Achieve good scapula setting.
• Regain 75% of intra-operative ROM.

Phase 2: 15 Days–6 Weeks

Goals:

1. Reduce Pain and Inflammation:
   • Continue manual therapy, taping, and alternative strategies.
2. Restore ROM:
   • Achieve intra-operative PROM and progress to AROM with good SHR.
3. Re-establish Stability:
   • Focus on dynamic stability through controlled AROM and strengthening exercises.
4. Introduce Proprioception Training:
   • Begin proprioceptive exercises, core strengthening, and light sport-specific activities.
5. Scar Management:
   • Begin scar massage after stitches are removed.

Precautions:

• Avoid excessive or repetitive overhead loading.

Milestones:

• Minimal pain and inflammation.
• Full intra-operative PROM and good SHR during AROM.

Phase 3: 7–14 Weeks

Goals:

1. Achieve Full PROM:
   • Introduce multi-directional stretching and capsular stretches (especially for the posterior capsule).
2. Restore AROM:
   • Progress pre-operative AAROM and AROM with good SHR.
3. Strengthening and Stability:
   • Begin scapular stabilisation and rotator cuff strengthening, transitioning from isometric to isotonic exercises.
   • Focus on dynamic and rhythmic stabilisation exercises.
4. Proprioceptive and Core Strengthening:
   • Progress exercises in alignment with functional goals.

Precautions:

• Avoid heavy or repetitive overhead tasks.

Milestones at 14 Weeks:

• Pain and inflammation resolved.
• Full intra-operative AROM achieved with good SHR.

Phase 4: 3–9 Months

Goals:

1. Maintain ROM and Stability:
   • Continue PROM and AROM exercises with good SHR.
2. Advance Strengthening:
   • Progress scapular stabilisation, rotator cuff strengthening, and dynamic stabilisation exercises.
3. Functional and Sport-Specific Training:
   • Gradually increase activity intensity and specificity.

Milestones at 4 Months:

• Full pain-free motion with good SHR.

Contact Information

• Consultant Secretary: 07810 356433
• Sulis Hospital Physiotherapy: 01761 422388
• Circle Health Group Bath Clinic Physiotherapy: 01225 838767
• St. Joseph Physiotherapy: 01633 820321

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