What is Acromioclavicular Joint Injuries?
The AC (acromioclavicular) joint is the pointy protrusion near the top, outer edge of the shoulder in which allows you to lift your arm up above your head. These type of injuries are most common in younger active individuals in which range from sprains of the AC and coracoclavicular (CC) ligaments to complete dislocation of the AC joint.
What are the different types of AC injuries?
Type I and II AC injuries, where the ligament tears are incomplete and the joint is still intact, are treated conservatively. There is a great discussion of the best way to treat type III injuries. In these injuries, AC and CC ligaments as well as the joint capsule are ruptured, elevating the clavicle. The damage to the AC joint may injure the cartilage within the joint and can later cause arthritis of the joint.
What causes AC joint injuries?
AC joint injuries can be either direct or indirect where:
- Direct impact can be caused by collision or a fall onto the shoulder with the arm next to the body.
- Indirect injuries are less common but can occur after a fall onto an outstretched arm. It is common that the AC ligament is injured that the CC ligament. The type III injuries are most commonly seen after falling off or colliding with bicycles, in contact sports and in car accidents.
How do I know if have an AC joint injury?
You can be correctly diagnosed with an AC joint injuries by:
- Explaining your medical history
- Having a physical examination. In which will include looking at your step deformity any swelling or bruising, and feels for any tenderness over the AC joint and outer edge of the collarbone
- Your physiotherapist may lift your arm up and to 90 o and take it passively across your chest with the elbow flexed therefore testing the AC joint injury. If you endure pain during this it will confirm the AC joint is injured.
- Imaging such as X-Rays may be used to see how severe the injury is.
How can physiotherapy help with AC joint injuries?
Physiotherapy can help with Ac injuries in the following ways:
- In the early stage of the injury, you may be shown how to tape your AC joint and/or apply a sling so your forearm is supported, this will need to be completed for 3 to 4 weeks although this time will depend on the symptoms. If the pain has decreased significantly then you may only need to use the tape/sling for a week.
- Your physiotherapist can help educate you on how to support your arm whilst sleeping.
- You may be advised that ice could help swelling and bruising.
- After 1 to 2 weeks of the injury it may be suggested that you complete and after 4 to 6 weeks your physiotherapist may gently mobilise your shoulder joint and collarbone to prevent excessive scarring and improve joint mobility. Once you are in a pain free state, you will be given progressive resistive exercises.
What can I do at home?
You must ensure that you follow the instructions of your physiotherapist. Therefore ensuring you rest until the structure heals and not completing any activities that include lifting your arm across your body or lifting your arm past 90o or driving. You may complete exercises for your legs and core but ensure these do not stress your shoulder. You may decide to ride a stationary exercise bike to maintain fitness.
How long will my recovery be?
Depending on the severity of the injury, your activities may be limited for more than six months. AC joint injuries treated without surgery do heal, although it is important to note that there is the potential for residual pain, inflammation and possible long-term degenerative changes. Some may feel this up to 10 years.
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Reference: Australian Physiotherapy Association 2019, Your Body, viewed 19 November 2019, < https://australian.physio/>.