AC Joint Sprain / Separated Shoulder
AC Joint Sprain / Separated Shoulder
What is an AC Joint Sprain / Separated Shoulder?
The joint that connects the outer end of your collarbone (clavicle) and the acromion process of your shoulder blade (scapula) is called acromioclavicular joint or AC joint. AC joint has a role in many of the movements of your arm. The AC joint also transmits forces from the arm to your body. The AC joint is help in place by strong ligaments called the; coracoacromial, acromioclavicular, and coracoclavicular (trapezoid and conoid). An AC joint sprain (or acromioclavicular joint separation aka a separated shoulder, not to be confused with a shoulder dislocation) refers to joint damage where these ligaments are overstretched, and/or torn. The severity of damage varies from mild sprains all the way up to complete tears of the ligaments.
AC joint injuries are graded according to “Rockwood Scale”, and are as follows:
- Grade l: The joint is mildly sprained with slight damage to the ligament. There is no displacement of the clavicle.
- Grade ll: The joint ligaments are severely torn. A slight displacement of the clavicle is apparent. There may also be a partial tear of the coracoclavicular ligament in the region.
- Grade lll: Most of the ligaments are torn. There is a visible lump or step as the sign of an upward displaced collarbone.
- Grade IV: Posterior displacement of the collarbone
- Grade V: Upward displacement of the collar bone to a greater degree than Grade III
- Grade VI: All the ac joint shoulder ligaments are torn. Downward dislocation of the collar bone
Causes of an AC joint sprain
Your AC joint could be injured by a direct blow; for instance when the shoulder hits the ground in American football or rugby. The AC joint could also be damaged by indirect forces when someone falls on an extended arm.
Symptoms of an AC joint sprain
If you have the following symptoms, then you may have an AC joint sprain:
- Difficulty in shoulder movement: Cradling the arm
- Shoulder pain intensified by pushing or pulling movements with the affected arm, lifting loads, and across the body and overhead movements.
- Swollen and/ bruising over the ac joint shoulder
- A bulge or step on the shoulder in cases of ac joint ligament tears
Medical Treatment of an AC joint sprain
Most cases of Ac joint sprains begin to recover within a few weeks but there are some more severe cases that need careful management to avoid permanent shoulder damage.
Following procedures are performed to protect your sprained joint and accelerate the healing process:
- Slings: To ease the pain and pressure on your AC joint ligaments by taking the weight of your arm
- Taping: To immobilize and support the joint
- Ice: To reduce the inflammation and pain
- Shoulder brace: To de-load the injured AC joint
- Medications: Anti- inflammatory drugs
- Injections: Corticosteroids determined by a Sports Medicine Specialist
- Surgery: In grade IV, V, VI, and in grade III cases that don’t respond to non-invasive conventional treatments. Post-operative Physiotherapy rehabilitation is required.
The aims of Physiotherapy are:
- Pain reduction
- Inflammation reduction
- Returning joint range of motion to normal condition
- Giving strength to the joint
- Shoulder alignment improvement
- Providing normal muscle length
- The instruction of preventive measures
Different techniques are employed in Physiotherapy including:
- Supportive: slings, taping
- Immobilization and mobilization of the joint
- TENS: To ease the pain in severe cases
- Ice and heat packs
- Ultrasound: For minor injuries
- Laser therapy
- Supervised exercises (example AC joint exercises includes; Pendulum exercises, Shoulder Blade Squeezes, front shoulder stretch, External rotation stretch, Isometric shoulder strengthening)
- Rehabilitation education
Keep in mind that if an AC joint injury is not properly treated, it could cause permanent functional shoulder problems and long term deformity in the form of a bump on your shoulder.
Shorten the healing period of your AC joint sprain!
You can speed up the healing process and rehab of your AC joint injury by consulting with one of our expert Physiotherapists in Toronto and getting an individualized treatment and rehab plan.