| Phase | Rehabilitation | Precautions |
| Day 0 | Sling for 4–6 weeks; hand/elbow/wrist mobilisation; immobilise ACJ (depending on fixation used). | No horizontal adduction or crossing arm for 8 weeks. Keep shoulder in neutral. |
| 0–2 weeks | Begin pendulums; gentle passive flexion/abd to 90°. Scapular retraction exercises. | Maintain sling except for exercises; avoid any load on ACJ. |
| 2–4 weeks | Continue passive ROM to shoulder height; at ~3 weeks, wean from sling to day use only. Active ROM in safe ranges. | No lifting heavier than a cup; avoid cross-body or wide arm positions. |
| 4–6 weeks | Full passive and active flexion/abd; isometric deltoid/cuff in neutral. | Sling out completely by 6 weeks; avoid sudden jerks on AC. |
| 6–12 weeks | Progress strengthening (resisted flexion, abduction up to 90°). Introduce gentle cross-body ROM after 8 weeks. | Resume more aggressive movements after 8 weeks per fixation check. |
| 12+ weeks | Return to full shoulder movements; resume sports/ heavy lifting from ~4–6 months. |
Protocol essentially identical to acute ACJ stabilisation , since the repair is protected similarly. Follow the same timeline and precautions as above. Emphasize avoiding cross-body load for 8 weeks, with full return by 3–4 months.