AC joint separations are common injuries, especially for athletes competing in contact sports like football. Separations are graded depending on their severity. While severe sprains may require surgery, most do not. Whether surgery is needed or not, physical therapy is required following an AC joint separation to improve your range-of-motion and strengthen the muscles in your shoulder.
Definition
Your AC joint, or acromioclavicular joint, is the point at which your scapula (shoulder blade) connects to your clavicle (collarbone). Together, these two bones help comprise your shoulder by forming a socket that holds your upper arm bone. An AC joint separation occurs when the ligaments that connect your scapula and clavicle are torn or stretched. According to Cedars-Sinai Medical Center, it is usually the result of falling or being hit on the point of the shoulder blade or an outstretched arm. AC separations are classified by grades, from 1 to 6, depending on their severity. Grade 1 is a mild sprain of the AC ligament, while grade 6 is a complete tear of the ligament and a dislocation of your clavicle.
Treatment
Your treatment depends largely on the severity of the injury. If you suffer a grade 4 through 6 separation, you will probably need surgery. However, according to Cedars-Sinai, most AC separations can be treated without surgery by using conservative methods. Surgery involves reconstructing the ligaments and possibly using pins and plates to provide stability in the joint. Conservative methods include using ice, pain medications, and putting your arm in a sling. Regardless of the type of treatment you receive, physical therapy is needed to regain strength and range-of-motion in your shoulder.
Passive Exercise
Physical therapy can begin once your pain eases. Passive exercises help to improve the range-of-motion in your shoulder. You will start with passive exercises. During these exercises, your shoulder joint is moved, but your muscles stay relaxed. Your physical therapist will move the joint so that you do not need to move your muscles, allowing them time to heal.
Active Exercise
Your program will progress to active exercise once your ligaments have had time to heal. These exercises require the use of your muscles and help you regain shoulder movement. They work your muscles without putting stress on your injured joint. Over time, you will begin more active strengthening. Cedars-Sinai states that this will focus on improving strength and control of the rotator cuff muscles and the muscles around the shoulder blade, helping your shoulder to move smoothly.
