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AC joint injuries can often avoid surgery.

Injuries to AC joints are common among athletes. Two of the most common ways people injure their AC joints are by falling on their outstretched arm or running directly into something.

What is the AC joint, and what symptoms should I look for to know it's an AC joint injury?

Your shoulder is formed at the junction of the clavicle, the scapula and the humerus. The joint between the end of the scapula (the acromion) and the clavicle is called the acromioclavicular (AC) joint. This is one of the important functional joints, allowing a full range of movement in the shoulder joint held together by three ligaments--the acromioclavicular, coracoclavicular and coracoacromial ligaments.

What are some of the signs and symptoms of an AC injury?

Here are some indicators:

* Pain on the top of the shoulder.

* Pain when lying on the involved side.

* Pain increases with heavy lifting or overhead and across-body movements.

* Swelling and bruising along the shoulder.

* Tenderness over the AC joint.

* Decreased range of motion and stability.

* Decreased strength.

* Visible bump on the top of the shoulder.

* Popping sound or catching sensation.

What are the most common causes of AC joint pain?

Among the most common are:

* Chronic irritation from repetitive overhead motions in sports such as baseball, weightlifting, volleyball and basketball.

* Contact sports with a high risk for falls and collisions, such as football, wrestling, rugby, biking, hockey and snow sports.

What are the different types of AC joint injuries?

Six types of injury have been identified:

* Type 1: When the force applied to the acromioclavicular and coracoclavicular ligaments is too mild to tear them. This will result in only a sprain of the AC joint. It will hurt but not show any evidence of an acromioclavicular joint dislocation.

* Type II: When heavier force is applied to the shoulder, disrupting the AC ligaments but leaving the coracoclavicular ligaments intact but sprained. When these injuries occur, the lateral clavicle becomes more prominent.

* Type III: When the force applied to the shoulder completely disrupts the AC ligaments and coracoclavicular ligaments, leading to complete separation of the clavicle and the resulting protrusion or bump.

* Type IV: When there is posterior displacement of the clavicle, buttonholing through the trapezius muscle.

* Type V: When the clavicle is widely displaced as a result of disruption of muscle attachments.

* Type VI: This is rare, but when there is inferior displacement of the distal clavicle below the acromial process or the coracoid process.

Can physical therapy help?

Once the AC joint is officially diagnosed, your physician will work with you to develop an individualized plan to start your recovery. Most patients with AC joint injuries will start to feel better within a few days or a week, but the truth is, it can take at least six weeks for the AC ligaments to fully heal. During that time, it's crucial to take the pressure off the joint to protect from overstretching the immature scar tissue. While it's helpful to use a sling, tape or a shoulder brace to deload your AC joint, physical therapy will be the key to most AC joint injury recovery plans.

What are the goals of physical therapy treatment for AC joint injuries?

The four main goals are as follows:

* Range of motion--regain ability to move without pain.

* Strength training--regain strength in the shoulder to better prevent reinjury.

* Pain management--reduce the amount of residual pain as you go about your normal activities.

* Functional training--increase your ability to move your shoulder correctly without putting undue pressure on your AC joint.

Is surgery required?

If pain persists or if a severe deformity develops, surgery might be the best option to regain function of your shoulder. If there is a significant deformity and the ligaments are torn, the orthopedic surgeon will reconstruct the ligaments and possibly use a plate to help the joint heal. The plate would be removed after the joint heals adequately.

By Robert Rolf
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Title Annotation:HEALTH
Author:Rolf, Robert
Date:Nov 1, 2019
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