In the world of sports and athletics many of us have had slips, falls and bumps and bruises. In contact sports specifically there are a few injuries that are more predominant than others and one of those injuries is called an ‘Acromioclavicular or AC joint sprain or dislocation’. In my role as a hockey trainer for several years I have seen many of these injuries and they happen in different ways with varying levels of severity.
An AC joint sprain or dislocation occurs most often when there is a fall or trauma to the outer portion “the point” of the shoulder. This area of the shoulder is where the clavicle (collarbone) meets the shoulder blade at the top outside corner and can often be felt rather easily. The injury itself occurs when you have a separation of the clavicle away from the shoulder blade. This means that there is an actual tear to the ligaments that support the AC joint. Depending on the amount of trauma the injury has different severities and is classified by using a grading system. Depending on the grades there are different methods of treatment.
Grade 1 AC Joint Injury
Most common AC joint injury. A minor displacement of the joint. The AC joint ligament may be stretched or partially torn. Recovery is about 2 weeks.
Grade 2 AC Joint Injury
A partial dislocation of the joint but displacement may be seen on imaging. The acromioclavicular ligament is completely torn, while the coracoclavicular ligaments remain intact. Recovery time is about 6 weeks.
Grade 3 AC Joint Injury
A complete separation of the joint. Usually, the displacement is obvious on clinical exams and the shoulder tends to sag downwards under the weight of the arm. Recovery time is approximately 12 weeks.
Grades 4-6 AC Joint Injuries
These are less common and are more severe in nature. These are often surgical cases due to the involvement of other structures.
Chiropractic, Physiotherapy or Massage Therapy Treatment Options for AC Joint Injuries
Treatment options for grades 1 -3 are usually done with conservative therapy carried out by a physiotherapist, chiropractor or massage therapist. Treatment will usually consist of stabilizing the joint as best as possible, followed by bringing blood flow to the area to enhance healing of the ligaments involved. Treatment can include icing (initially), taping, acupuncture, anti-inflammatories, soft tissue treatment to surrounding muscles and shockwave therapy.
Best Exercises for Recovery from AC Joint Injuries
The best exercises for recovery from an AC joint injury vary depending on the stage and degree of injury. As a general rule of thumb you want to have free range of motion of the shoulder before getting started with strengthening exercises. Thus, it is a good idea to avoid any strengthening or overhead exercises until this is achieved. Some exercises that can be started once this is attained are shoulder pendulums, isometric shoulder strengthening and resistance band work. To know exactly what exercises to carry out and when, you can consult our knowledgeable staff at Rebalance Sports Medicine with any questions or concerns.
AC Joint Injury Prevention
Once an AC joint injury is healed and you have returned to sport or physical activity, it is crucial to remember to continue with proper maintenance of the shoulder. This includes the correct strengthening exercises and mobility drills to ensure the best shoulder health. This may also include using the necessary bracing if needed.
Overall an AC Joint injury or separation can be a complicated injury as the shoulder is a very complex joint, but if diagnosed correctly by knowledgeable health care practitioners it can save you a lot of frustration and enhance your recovery time.