The shoulder is the most mobile joint in the human body with a complex arrangement of structures working together to provide the necessary movement. The shoulder is a ball-and-socket joint made up by the humerus (the ball) and the glenoid (the socket). A strong network of soft tissues, muscles, and bones work cohesively to provide movement and stability to the shoulder. The head of the humerus fits into a shallow socket in the scapula, called the glenoid fossa, while the shoulder capsule, a strong connective tissue, surrounds the shoulder joint. Synovial fluid lubricates the joint and the shoulder capsule to ease the movement of the shoulder. Show OverviewThe acromioclavicular joint, often referred to as the AC joint, is where the clavicle (collarbone) meets the highest point of the scapula (shoulder blade) which is called the acromion. There are ligaments, which are tough bands of tissue, which hold the clavicle and the scapula together and help stabilize the joint by restricting excessive movement. An AC separation, also known as a shoulder separation, is an injury to the ligaments holding your AC joint together. An AC separation is a common injury among athletes and active individuals participating in contact sports such as football and hockey, but can happen to anyone who falls and lands on the tip of their shoulder or elbow. AC separations are often confused with shoulder dislocations, which involve the separation of the glenohumeral joint as opposed to the AC joint. SymptomsIndividuals who are experiencing an AC separation have the following signs and symptoms:
If the pain and tenderness near the end of the clavicle persist, a visit to a physician is highly recommended to rule out other conditions or avoid further damage. DiagnosisAn AC separation can typically be identified during a physical examination, especially if it has caused a deformity. The physician will examine the shoulder to test the range of motion of the shoulder joint. When there is less or no visible deformity, the location of the pain as well as X-rays help the physician make the diagnosis. Even mild AC joint injuries can be extremely painful and x-rays may appear normal. However, they can help diagnose the extent of the injury and are also important in ruling out a fracture at the end of the clavicle. An AC separation is typically classified into six grades with the first three being the most common and the last three being less common: Grade 1: Mild Separation - A mild shoulder separation involves a sprain of the AC ligament which does not move the clavicle and looks completely normal on X-rays. Grade 2: Moderate Separation - A moderate shoulder separation involves a tear of the AC ligament or partial tear of the coracoclavicular (CC) ligament which moves the clavicle out of alignment to some extent. Grade 3: Severe Separation - A severe shoulder separation involves complete tears of both the AC and CC ligaments and moves the clavicle noticeably out of alignment. Grades 4-6 - These injuries cause a significant degree of instability and movement through the AC joint and may require surgical stabilization. TreatmentTreatment of an AC separation depends on the grade of the injury and the extent of pain the individual is experiencing. Most AC separations are treated non-operatively and the individual is able to return to all sports and activities with a fully functional shoulder, although a bump may be present. Rest - It is advised to decrease or completely stop the activity that makes the pain worse. A great way to stay active while allowing the symptoms to subside is to switch to low-impact, cross-training activities such as biking or elliptical machine. Ice - Placing ice (with a barrier such as a towel) on the most painful areas of the shoulder for up to 30 minutes (less if the skin becomes numb), three to four times a day can greatly soothe the pain and keep the swelling down during the first 48 hours. Medication - Over-the-counter anti-inflammatory medication such as ibuprofen and naproxen usually help reduce pain and swelling. Physical Therapy - Physical Therapists will often prescribe specific strengthening and range of motion exercises that promote healing and help recover as much mobility in the shoulder joint as possible. It is crucial that these exercises be done accurately and routinely to optimize recovery of the mobility of the shoulder joint. The physician may require you to wear a sling for a few days until the pain subsides. Surgery - If conservative treatments and other procedures have not helped reduce symptoms, the physician may recommend surgery to reduce pain or restore function and stability.
RecoveryAfter sustaining an injury to the AC joint, some patients develop persistent pain related to osteoarthritis, or deterioration of cartilage, of the AC joint. Regardless of the treatment approach taken, patients go through a rehabilitation program which includes physical therapy exercises that are crucial to restore range of motion. Most individuals heal and return to their previous level of activity within two to three months of non-operative treatment. However, some patients do require surgery. Each patient is unique, so the therapy program will vary based on his/her level of pain, extent of injury, and desired level of activity they would like to return to. Recovery after surgery can take anywhere from six weeks to three months depending on the complexity of the procedure, but the individual's commitment to following all the instructions and guidelines given by the physician and the exercises prescribed by the physical therapist is an important factor in returning to all the desired activities. DisclaimerCALL 911 IMMEDIATELY IF YOU ARE HAVING A MEDICAL EMERGENCY! The information provided on this website or through links to other sites, is for patient education purposes only and NOT a substitute for professional medical care. This website contains general, non-exhaustive information about common conditions and treatments and should not be used in the place of a visit or the advice of your physician or healthcare provider. If you think you may be suffering from any medical condition you should seek immediate medical attention. Reliance on the information appearing on this site and any linked sites is solely at your own risk. How do you know if your AC joints are separated?What Are the Symptoms of an AC Joint Separation?. Bruising.. Swelling.. Weakness in the upper arm or shoulder.. A visible deformity, typically a bump at the top of the shoulder.. What special test is used to determine if AC separation?The shoulder special test for an AC joint separation is called the AC joint compression test. It's a simple test to perform, and your PT or healthcare provider may do this as part of your evaluation for shoulder pain or problems.
How do you check AC joint?The AC joint is located where the clavicle, or collar bone, meets the acromion, the highest part of the shoulder blade. This joint doesn't move much, but it does enable some specific movements, such as raising the arm above the head or across the body.
What do you do for AC joint separation?Treatment is typically an arm sling, bed rest, ice and heat therapy, and anti-inflammatory drugs. Most people recover full motion of the shoulder and arm within 6 to 8 weeks, often with the assistance of physiotherapy.
|