AC Joint injury and Physiotherapy

The AC Joint

The acromioclavicular joint is where the acromion of your scapula meets the clavicle bone on the front of your chest/shoulder.

 

Presentation

An AC joint sprain is a common sporting injury caused when an athlete falls onto the point of the shoulder. This injury may present with swelling and bruising, general soreness at the top of the shoulder and pain with movement. In some cases, the shoulder will have a “step deformity” where the bones of the joint have been visibly separated. This separation may decrease with healing of the ligaments, rehab and exercise (brukner & khan, 2012). Your Physiotherapist will grade the injury depending on severity using a selection of clinical tests, taking in to consideration the story of how it was injured.

 

Signs

  • Pain and tenderness over the joint
  • Pain may radiate into the neck and shoulder muscles and even down the arm
  • Difficult activities: reaching across body, putting arm overhead, reaching behind body, carrying
  • Pain during the night affecting sleep

Treatment

  • Immediate management involves resting, icing, compression and elevation of the shoulder.
  • Type 1 and 2 injuries are conservatively managed using rest and Physiotherapy.
  • Higher grade sprains (3 and above) will often be treated with a surgical repair.
  • After the acute stage a physiotherapist can perform manual therapy techniques to decrease the stiffness of the shoulder and decrease pain and apprehension.
  • Strengthening exercises for the shoulder and scapular muscles are very important in this injury to secure the joint and to also prevent the injury from happening again.
  • Upon return to sport or work the athlete/worker may like to tape the shoulder for extra support (sports medicine australia, 2016).

 

Return to sport and full function

Recovery time frame will vary depending on grade of injury and can range between 2-6 weeks for lower grade injuries. Return to sport is considered when there is

  • Full and pain free range of motion of the affected shoulder
  • Normal strength in all positions for the shoulder, particularly flexion and horizontal abduction/adduction
  • Sport specific skills can be performed pain free
  • Tape may be used to help support the joint

 

References

  1. Acromioclavicular (ac) joint injury | sports medicine australia. (2016). Sma.org.au. Retrieved 28 september 2016, from http://sma.org.au/resources-advice/injury-fact-sheets/acromioclavicular-ac-joint-injury/
  2. Brukner, p., khan, k., & brukner, p. (2012). Brukner & khan’s clinical sports medicine(pp. 369-371). Sydney: mcgraw-hill.

 

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