Acromioclavicular osteolysis is a prevalent condition among heavy laborers and power weightlifters. Although the large majority of reported cases occur in men, more women are suffering from this condition if they participate in heavy physical work or participate in powerlifting training. Understanding the causes and treatments will guide you in recovering from your acromioclavicular osteolysis.
Cause and Location of Injury
The acromioclavicular joint is located at the juncture where the outside end of the clavicle intersects with the acromion process of the shoulder blade. The joint is thus located at the top of the shoulder. Associated with heavy overhead lifting activites, acromioclavicular osteolysis is essentially a stress fracture at the joint. This injury is generally the result of cumulative trauma, although it can be jump-started by an acute injury.
Diagnostic Tests
Your doctor will perform a palpation test, pressing with mild to moderate pressure against the location of the acromioclavicular joint. If this test elicits pain, you may have acromioclavicular osteolysis. The Scarf test can also be performed. In this test, your doctor will have you bend your elbow, then push your arm across your chest to forcibly adduct your shoulder. This test would not cause pain in a healthy shoulder. The best diagnostic test for acromioclavicular osteolysis is an X-ray, which would confirm the degeneration of the bone at the acromioclavicular joint.
Physical Therapy
Physical therapy for AC osteolysis centers around pain relief and muscle strengthening. Your physical therapist will teach you exercises to strengthen your deltoid and trapezius muscles. Furthermore, your physical therapist may use ultrasound, electrical stimulation, iontophoresis and infrared heat to reduce pain and encourage bone regeneration. Your therapist can teach you alternative, safer ways to perform the activities that caused your injury to decrease your risk of chronic issues.
Alternative Treatments
The most important aspect of recovery is rest of the acromioclavicular joint and the associated activities for at least six weeks. Follow up with your orthopedic doctor for a repeat X-ray to ensure proper healing of the bone before resuming your heavy lifting activities. You can use anti-inflammatory medications for pain and edema control; however, these can slow the bone-healing process. Your orthopedic doctor may also recommend a steroid injection to provide pain relief for a few months while the bone regenerates. In the most severe cases, or for those with poor circulation who may not heal independently, your surgeon may perform a arthroscopic removal of the affected, non-healing bone.
