The Acromioclavicular, or AC, joint is where the top of the scapula, also called the acromion, meets the clavicle. If you fall and land directly on your shoulder, you may experience pain and possibly a separation of the acromion from the clavicle, also called a separated shoulder. Rehabilitation for this type of injury usually starts with immediate treatment then moves on to exercises to increase your range of motion and strength.
After-Injury Treatment
The first step in the rehabilitation process is to reduce the swelling and pain in the joint before attempting to move or strengthen it. You should apply ice directly to the acromioclavicular joint and rest the affected arm. Ice should be applied in 20-minute increments each hour as tolerated and as necessary. You may want to take non-steroidal anti-inflammatory drugs to help reduce the swelling and alleviate the pain. If you notice a significant amount of pain when your arm is hanging at your side, you can wear a sling to take the weight of your arm off your AC joint.
Range of Motion Exercises
These exercises are used early in the recovery and rehabilitation process and are designed to maintain the mobility and flexibility of the AC joint. The pendulum swing is a commonly used exercise to help open the joint and relieve pain, and to help avoid experiencing a frozen shoulder.
Perform the pendulum swing by bending at the waist and allowing the weight of your arm to pull it toward the ground. You should gently shift your weight back and forth to swing your arm in a small circle. When the pain begins to subside, you should check with your physical therapist or doctor to find out when you can start stretching your shoulder to increase your flexibility. You can do this three to seven days each week, and you may increase the difficulty over time by adding hand weights to the exercises.
Strengthening Exercises
Muscle-strengthening exercises are necessary to build stability in the shoulder and help prevent future injuries. As your pain decreases, you may increase the difficulty of the strengthening exercises. Start by strengthening your shoulder with isometric exercises, or exercises that engage the muscle and hold it in the contracted form. To do this for your shoulder abductors, stand with your injured shoulder next to a wall with your arm down at your side and press your wrist outward into the wall. For internal rotation, stand facing a small wall with your arm slightly bent and place your fist on the outside of that wall with the inside of your wrist touching the wall. Try to rotate your arm at the shoulder in toward the wall, holding this for 20 seconds. Repeat for the external rotators by placing the back of your wrist against the other side of the wall and trying to rotate the arm outward.
Warnings
Avoid sleeping on the injured side of your body. You should also avoid any overhead reaching, lifting, putting weight on the arm of the injured side of your body and reaching across your body. Avoid performing any exercises during the rehabilitation process that cause a sharp pain or tearing sensation in your shoulder. Check with your doctor before returning to normal activity or sports involving your shoulder. The doctor will need to make sure you have a pain-free range of motion and enough strength in the muscles surrounding the AV joint to avoid re-injuring the joint.
References
- American Academy of Orthopaedic Surgeons; Shoulder Separation; Oct 2007
- American Family Physician; Management of Shoulder Impingement Syndrome and Rotator Cuff Tears; Allen E. Fongemie, et al.; 1998
- EurekAlert; Healing a Shoulder Separation; Lauren Pearson; April 2009
- Up To Date; Patient Information: Acromioclavicular Joint Injury; Scott M. Koehler; Jan. 2011
- Southern California Orthopedic Institute: The AC Joint
- Sports Injury Clinic: Rehabilitation of AC Joint Injuries
