2 min read • October 20, 2022
Posted in
By Eric Chang
The AC joint is a joint in the upper part of the shoulder where two bones come together. The acromion is one of these bones which is part of the shoulder blade (scapula), while the other bone is the collar bone (clavicle). Like other joints in the body, there is cartilage at the AC joint which allows the bones to glide smoothly. Most AC joint injuries involve the acromioclavicular ligament and the coracoclavicular ligament as these two ligaments are a major component of the stability of the AC joint. The acromioclavicular ligament connects the acromion to the clavicle, while the coracoclavicular ligament connects the clavicle to the coracoid process, which is a part of the scapula.
AC separation describes a condition in which the clavicle and the acromion are no longer in proper alignment, due to an injury to the ligaments holding the AC joint in place.
Pain at the top of the shoulder
Pain when lifting the arm up overhead
Swelling
Reduced range of motion of the shoulder
A bulge on the shoulder
Direct fall onto the shoulder
Fall onto an outstretched hand
Direct hit to the shoulder
An x-ray is usually performed in order to determine the severity of the injury. AC joint separations range from mild to severe. Grade 1 injuries only involve a partial tear of the acromioclavicular ligament. Grade 2 injuries involve a complete tear of the acromioclavicular ligament with partial tearing of the coracoclavicular ligament. Grade 3 injuries involve a complete tear of both the acromioclavicular and coracoclavicular ligaments.
Low grade sprains can be managed with conservative treatment, including rest and physical therapy with strengthening exercises until symptoms improve. Depending on the severity of the injury, your doctor may place you in a sling in order to immobilize the shoulder. In most cases, surgery is not required in order to make a full recovery, however, some sports medicine doctors may recommend surgery for elite athletes that throw a lot, such as a quarterback in the National Football League (NFL) or a pitcher in Major League Baseball (MLB). Grade 1 injuries usually heal within two weeks, while grade 3 injuries may require up to two months in order to fully heal. In rare cases where surgery is indicated, such as when AC separation causes severe deformities of the shoulder, recovery times will be longer. Physical examination and medical history are important determining factors as to whether or not a patient needs surgery. If you have an AC joint injury, you may need to see a sports medicine physician to help decide which treatment is right for you.
If a football player wishes to continue practicing with an injury, it is wise for coaches to make practice non-contact for the injured player while they are recovering. This can help the athlete stay active and in shape throughout the recovery process. Athletes that play quarterback or athletes in other sports that require repetitive throwing motions may have to limit their activity during practice or stop throwing entirely, depending on the severity of the injury and what the athlete can tolerate. Again, it is recommended that you see a sports medicine physician to help decide how to approach practice during recovery.
Patients are typically advised to avoid lifting weights with an AC injury as it can aggravate their symptoms and delay healing. However, you can workout as long as you avoid exercises that place stress on the AC joint. Common exercises to avoid are the bench press, push-ups, dips, and lateral raises, as these can all worsen your injury and delay the recovery. If you are performing an exercise that causes any discomfort in the shoulder area, you should stop performing the exercise immediately.
As with any injury, rest is one of the best ways to recover from an AC joint injury. Be sure to not accidentally rest in positions that may aggravate the injury, such as laying down on the shoulder or keeping your arm overhead. Your doctor may provide you with a sling depending on the severity of the injury, which should be used as directed. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen may be prescribed in order to reduce pain and swelling. Physical therapy may also be advised to help strengthen the muscles in the shoulder to improve stability of the injured area.
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