AC Joint Separation
An Acromioclavicular Joint Separation, or an AC Joint sprain, is a very common shoulder injury. It involves the ligaments which hold the acromioclavicular joint together at the top of the shoulder. Falling onto an outstretched arm is the most common cause, particularly in sports such as cycling, snowboarding, skiing, or football.
The injury can be mild, moderate, or severe. A minor AC joint sprain involves stretching of the ligaments only. In a severe (Grade 3 – 5) injury, the ligaments that hold down the clavicle are ruptured, and the end of the collar bone appears very prominent, causing a bump on the shoulder. Symptoms can range from mild tenderness to severe pain associated with a complete separation.
For more information on AC joint separation and your possible treatment options, call +44 (0) 203 195 2442 to arrange a consultation with the London Shoulder Specialists.
How is AC Joint Separation treated?
Immediate first aid for an AC Joint Separation will involve the RICE protocol (rest, ice, and compression) and anti-inflammatory medication. A mild injury can be treated with a sling or brace followed by physical therapy, taking a few weeks to heal.
If you are concerned about the extent of the injury, a London Shoulder Specialists consultant can assess the severity of the ligament damage. They will carry out a thorough physical examination, and the diagnosis will be supported with an X-ray or MRI scan to assess the amount of damage. After this, your shoulder consultant can advise you on the most appropriate treatment plan, including surgical and non-surgical options.
If a more severe injury (Grade 3 or above) of the joint is diagnosed, surgery will normally be recommended, especially for high-level throwing athletes or anyone involved in heavy or overhead manual work.
What does surgery for AC Joint Separation entail?
Surgery for AC Joint Separation involves an incision on top of the shoulder and the joint is put back into its correct position. Sometimes an implant will be used to hold it in place while the ligaments heal, and the damaged end of the collar bone may be tidied up.
After surgery, it will normally take up to 12 – 16 weeks for a full recovery and a return to sports/normal activities. However, this will involve following a program of strengthening exercises, directed by a physical therapist.
For those who choose not to have surgery, there is the possibility that it could be performed later, if circumstances require.
Frequently Asked Questions on AC Joint Separation
HOW IS AN AC JOINT SEPARATION DIAGNOSED?
A Grade I AC Joint Separation presents as a slight displacement of the joint and the acromioclavicular ligament may be stretched or even partially torn.
A Grade II AC Joint Separation is a partial dislocation of the joint and the acromioclavicular ligament is completely torn, while the coracoclavicular ligaments are still intact.
In a Grade III AC Joint Separation, the joint is completely separated and both the acromioclavicular and the coracoclavicular ligaments are torn. The capsule surrounding the joint is usually torn as well. The displacement is obvious and a bump on the shoulder forms as the clavicle is pushed up.
In a Grade IV AC Joint Separation, the collar bone is pushed backwards in the horizontal rather than the vertical plane.
In a Grade V AC Joint Separation, the disruption is again complete, and the joint is markedly separated with a very significant deformity.
IS SURGERY ALWAYS NECESSARY?
Most AC separations can be managed with conservative treatment. However, more severe AC separations that leave the joint unstable usually require surgical intervention for a full return to normal activities.
WILL THE ‘BUMP’ REMAIN?
Without surgery, the minor cosmetic deformity will remain although it will not interfere with overhead activities and it will not hurt.
If you have further questions about possible treatment options for AC Joint Separation, please arrange a consultation with the London Shoulder Specialists.