The acromioclavicular (AC) joint is a vital part of the structure and function of the shoulder joint. It is located at the top of the shoulder where the front of the shoulder blade (acromion) attaches to the collarbone (clavicle).
The AC joint is supported by the joint capsule and strong ligaments (acromioclavicular and coracoclavicular ligaments) which are usually damaged in the most common injuries to the AC Joint.
AC joint injuries can be caused by a traumatic event which can force the acromion down underneath the clavicle. This may include:
A fall directly on the outside of the shoulder
A fall onto an outstretched arm
A collision in team sports with another player
Or, by repetitive overuse:
Lifting heavy weights overhead
Excessive carrying of heavy weights
AC joint injuries are most common in individuals younger than 35 years of age, with males sustaining more traumatic AC joint injuries than females.
Because younger athletes are most likely to participate in high-risk and collision activities, such as football, biking, snow sports, and rugby, traumatic AC joint injuries occur most often in this population.
AC joint pain can also occur due to osteoarthritis in older individuals. This can be a normal part of ageing when shoulder and AC joints are strong and mobile, often this doesn’t cause any pain or symptoms.
AC joint injuries can be identified and effectively treated by a physiotherapist.
Symptoms of AC Joint Injuries include:
With an AC joint injury, you may experience:
General shoulder pain and swelling
Swelling and tenderness over the AC joint
Loss of shoulder strength
A visible bump above the shoulder
Pain when lying on the involved side
Loss of shoulder motion
A popping sound or catching sensation with movement of the shoulder
Discomfort with daily activities that stress the AC joint, like lifting objects overhead, reaching across your body, or carrying heavy objects at your side
Grades of AC Joint Injury
Grade 1 - Pain and discomfort will be experienced due to partial damage to the AC joint capsule and ligaments. Return to play may take up to 3 weeks.
Grade 2 - Involves complete rupture of the acromioclavicular ligament and partial tear of the coracoclavicular ligaments allowing the clavicle to move upward often resulting in a visible bump on the shoulder. Return to play will take a minimum of 4-6 week for these injuries
Grade 3 - Complete dislocation due to complete rupture of both ligaments. Return to play timeframes are dependent on management as surgery may be required in severe cases.
Imaging and Surgery for AC Joint Injuries
The majority of patients with AC joint injuries will not require surgery to return to sport. Even most grade 3 injuries will allow for a full return to activities with few restrictions with non-surgical management.
X-rays are often not required unless there is severe displacement of the joint as an AC joint injury can be diagnosed clinically and imaging will rarely change initial management.
Physiotherapy for AC Joint Injuries IN MELBOURNE:
Physiotherapists are experts in managing AC joint injuries and typical management involves an individualised assessment and treatment plan considering the following components:
Range of Motion Exercises.
An injury to the AC joint, whether traumatic or overuse, causes the joint to be irritated, often resulting in swelling and stiffness, causing loss of normal motion. Your physiotherapist will assess your motion and the degree of your injury, and establish a plan that will balance joint protection and motion restoration.
Strength Training. for AC Joint Injuries .
After an injury, the surrounding muscles demonstrate weakness. Your physiotherapist will design an individualized exercise program to strengthen the muscles at and around the shoulder, so that each muscle is able to properly perform its job. Rotator cuff activation is very important at this stage.
Taping for AC Joint injuries.
Initially taping can help support the joint during the healing process, provide increased comfort and aid in controlling pain. Tape may also provide increased comfort when returning to sport.
Manual Therapy for AC Joint Injuries.
Physiotherapists are trained in manual (hands-on) therapy. If needed, your physiotherapist will gently move and mobilise your shoulder joint and surrounding muscles as needed to improve their motion, flexibility, and strength while helping to control pain.
Pain Management for AC Joint Injuries.
Your physiotherapist may recommend therapeutic modalities, such as ice and heat to aid in pain management.
The first step to addressing your shoulder pain is modified rest. The amount of rest required varies, and largely depends on the degree of your injury. Your physiotherapist will create a personalised plan for your rehabilitation, so you can safely return to your desired daily and recreational activities.
To book an appointment to see a Physiotherapist at Melbourne Sports Physiotherapy who are experts in the management of AC joint injuries and will work with you to get you back to your chosen sport as quickly as possible, pleaseBook Online or call your closest clinic.