Acromioclavicular joint sprain (acute)
The acromioclavicular joint (ACJ) is a common area of injury in sports, usually caused by a fall onto the bony tip of the shoulder or by a hard impact to the shoulder. The acromioclavicular joint is surrounded by a joint capsule, with additional support from ligaments (acromioclavicular ligaments and coracoclavicular ligament, which is made of […]
- Ice is the first point of management to minimise the extent of swelling and inflammation
- The NO HARM protocol should be applied: No Heat, No Alcohol, No Running and No Massage – this will avoid increasing swelling and bleeding in the affected area
- The injured joint is often immobilised in a sling (this can range from 2 days to 6 weeks depending on the grade of injury)
- Early activation exercises are an important tool to minimise the length of the injury. Once pain allows, this usually starts with early isometric exercises (that is, strengthening via contractions of a particular muscle or group of muscles in a still/ holding position. During isometric exercises, the muscle doesn’t noticeably change length and the affected joint doesn’t move)
Professional Medical Treatments
- An appropriate medical professional should be consulted as soon as possible to assess the extent of the injury. Often X-rays are taken in more serious injuries.
- A professional will aid in early rehab when appropriate and advice regarding active movements to optimise the function of the joint.
- Surgery is clearly indicated for type IV, V and VI injuries as well as type III injuries that have trialled and failed a conservative approach
- Return to play taping is usually warranted and will aid athlete comfort. An athlete is deemed return to play when there is full shoulder range (without pain), no local tenderness and no major loss of strength compared to pre-injury function. Grade I injuries often return to play within approximately 3 weeks. Grade II usually has a minimum of 4 – 6 weeks. Following this, more severe injuries can greatly differ depending on management (surgery v conservative) and extent of injury.
Physical Therapy Exercises
- Early isometric exercises (as described above) as well as early range exercises
- Progressive strengthening (often of the rotator cuff complex) following the immobilisation period. This is often completed using resistance band / dumb-bells
- Wearing protective strapping or padding can aid in prevention of ACJ injuries
- Generally an ACJ injury is from a direct fall or blow to the ACJ, therefore injury prevention can only go so far. Ensuring optimal shoulder function (range, strength and control) is always optimal.