A/C Joint Sprain
A/C or acromioclavicular joint sprain describes damage to one or more of the ligaments that stabilize the A/C joint. This can lead to pain, instability and/or separation. Sprains are classified on a grading scale consisting of three levels.
Grade 1 is over stretching of the ligaments.
Grade 2 is over stretching of the ligaments with some tearing.
Grade 3 is complete tearing of the ligaments.
A/C joint injuries are responsible for up to half of all athletic shoulder injuries. (1) They are more common in adolescents and young adults that partake in contract sports. A/C injuries typically happen following a fall onto the point of the shoulder with the arm tucked into the body or across the front of the body. Falling onto an outstretched hand or a seat belt injury are other common mechanisms of injury.
Individuals typically have pain and swelling on the top of their shoulder following acute trauma. Symptoms are often made worse with bench pressing, dips or trying to sleep on that side at night.
Treatment of an A/C injury depends on the grade. For a grade 1, once inflammation and swelling are managed, rehabilitation starts with regaining passive then active range of motion. Strengthening exercises are used to increase the dynamic stability of the joint. Cross body, forward elevation and behind the back moves are temporarily avoided. Pain tolerance dictates the progression of care. Grade 2 follows the same progression but spends more time managing inflammation and immobilization. Grade 3 are often referred to an orthopedic surgeon for further evaluation. The final stage of rehabilitation consists of functional activities that often replicate the loads of sport or work.
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The Brigham and Women's Hospital. Standard of Care: Acromioclavicular Joint Separation. The Brigham and Women's Hospital, Inc. Department of Rehabilitation Services. 2007.