AC sprain/ AC separation

The Acromioclavicular Joint (AC) is found on the top of the shoulder and is located between the collar bone and part of the shoulder blade defined as the acromion. Through this articulation, the collar bone can act as a strut maintaining the upper limb away from the thoracic cage and thus permitting a greater range of upper limb motion. The AC joint is supported by the acromioclavicular, coracoacromial ligament and coracoclavicular ligament.

Traumatic injury to the acromioclavicular joint either secondary to a fall onto the point of the shoulder, impaction to the front of the collar bone or a fall onto an outstretched hand, can lead to stretching of the ligaments which support the Acromioclavicular joint and a subsequent sprain.

As with any acute sprains, the patient will report pain and swelling. The pain is usually located over the front or top of the shoulder directly over the AC joint and there is often pain with overhead activities and downward pressure on the injured arm. As you can see on the image below of the right shoulder, there may also be a step deformity illustrating disruption of the AC joint  

Prior to commencing treatment it is important to stage the extent of injury so that the most appropriate treatment can be initiated. . There are 3 separate grading systems (Yochum and Rowe 1996)

AC sprain/ AC separation treatment

At the Bodymotion Chiropractic and Sports Injuries Clinic in EC2, we usually recommend in mild and moderate cases, conservative measures such as rest, ice and immobilisation (Kenny-Howard brace). The treatment can then gradually be progressed to ultrasound therapy directed at the injured AC joint, specific myofascial trigger point work directed at the shoulder girdle musculature and progressive shoulder range of motion exercises as well as specific stretching and strengthening exercises for the shoulder girdle.

In more severe cases, surgery may the option of choice. This usually involves repairing the injured ligaments. Once again, postsurgical rehabilitation is necessary to restore optimal function to the shoulder joint.