AC Joint Injuries (Acromio Clavicular Joint)
AC Joint Injuries
AC Joint injuries are often missed in hospital emergency departments after clavicle fractures and shoulder dislocations are ruled out. Those with AC Joint injuries are often left on their own, which can lead to inadequate AC Joint injury treatment.
Ongoing AC Joint dysfunction from a lack of correct diagnosis and rehabilitation can lead to chronic shoulder pain and poor sporting function. Book an appointment with your Physiotherapist for correctly getting your Shoulder injury diagnosed and treatment for your AC Joint injury.
Note: This page contains general advice on AC Joint injuries, which is intended for general education. Book an appointment with your Physiotherapist for more specific information about AC Joint injury treatment.
WHAT IS THE AC JOINT (ACROMIOCLAVICULAR JOINT)?
The AC Joint or acromioclavicular joint is a small joint between the acromium of the shoulder blade and the collarbone (Clavicle). It forms an important link between the arm and the skeleton and plays an important role when elevating the arm.
The AC Joint has a capsule and small AC Joint ligaments, which provide stability. Although the AC Joint ligaments are relatively weak, there are also two much stronger ligaments that attach the clavicle to a different point on the shoulder blade called the coracoid. These ligaments are termed the conoid and trapezoid ligaments and are collectively known as the coracoclavicular ligaments. They hold the clavicle in place and prevent it from being displaced upward.
CAUSE OF AC JOINT INJURIES
Traumatic AC Joint injuries are most commonly caused by a direct impact to the shoulder but can also occur due to a fall on an outstretched hand.
AC Joint injuries are common among cyclists after falls from their bike and in contact sports such as rugby and football.
GRADES OF AC JOINT INJURIES
Grade 1 AC Joint Injury – Minor damage of the ACJ ligaments without damage to the coracoclavicular ligaments. There is no displacement of the clavicle in a grade 1 AC Joint injury.
Grade 2 AC Joint Injury – Damage of the AC Joint ligaments as well as the coracoclavicular ligaments. There may be slight upward displacement of the clavicle in a grade 2 AC Joint injury.
Grade 3 AC Joint Injury – Rupture to the AC Joint ligaments and the coracoclavicular ligaments. There is significant upward translation of the clavicle leading to a step deformity in a grade 3 AC Joint injury.
Grade 4 and above – AC Joint Injuries can be considered variations of a grade 3 AC Joint injury and usually require surgery.
AC JOINT INJURY SYMPTOMS
Acute AC Joint Injury Symptoms:
AC Joint injuries are traumatic in nature resulting in significant pain at the point of injury. The pain is localized but may extend upward into the neck or down into the front of the shoulder. Depending of the severity of the AC Joint injury, there may be swelling and/or a bump at the end of the clavicle. There is usually an inability to raise the arm above shoulder height due to pain.
Semi-Acute AC Joint Injury Symptoms:
- Pain on palpation of the AC Joint
- Pain with elevation of the arm above shoulder height, sometimes only at the end of range
- Pain with reaching across the body and behind the body
- Pain and weakness when pushing weight and carrying significant weight, eg. push ups, bench press, shoulder press, chin ups.
AC JOINT INJURY TREATMENT
This section includes general advice on AC Joint injury treatment that may benefit you. Please see your Physiotherapist to ensure you receive the optimal AC Joint treatment directed towards your individual circumstances.
Physiotherapy Treatment for AC Joint Injuries:
Grade 1 AC Joint Injury Treatment:
- Sling or taping for comfort only
- Rest from aggravating activities
- Dry needling or massage to ease muscle tension and pain
- Gradually progressed strengthening exercises
- Graduated return to sport plan
Grade 2 and 3 AC Joint Injury Treatment:
- Sling for comfort and to allow soft tissue inflammation to settle
- Discussion regarding the benefits and risks of surgery. Please note that surgery must be performed in the first couple of weeks to ensure the best results (see below).
- Rest from aggravating activities
- Dry needling or massage to ease muscle tension and pain
- Gradually progressed strengthening exercises
- Graduated return to sport plan
Medical Treatment for AC Joint Injuries:
- Anti inflammatory medication
- Cortisone injection into the AC Joint if inflammation persists
Contact Us:
Do you need assistance with your injury? Experienced Physiotherapists with essential knowledge. You can call us anytime to have a confidential discussion with our expert Physiotherapists. For more information on how we can further assist you, please call our clinic number on 0479 080 800 or send us an email on [email protected] for further details. Our Physiotherapists are Medicare, NDIS, DVA and Work Cover approved, specialising in injury management and rehabilitation to get you back on track.
