Acromioclavicular Joint Separation Treatment Options

What is acromioclavicular joint separation?

Acromioclavicular (AC) joint separation refers to an injury involving the separation of the acromion (part of the shoulder blade) from the clavicle (collarbone). This type of injury commonly occurs due to a direct blow to the shoulder or a fall onto an outstretched arm, leading to damage of the ligaments that stabilize the AC joint. AC joint separations are graded based on the severity of ligament damage, with higher grades indicating more significant separation and instability.

How is AC joint separation treated?

Treatment for AC joint separation aims to address the underlying cause, alleviate symptoms, and restore function and stability to the shoulder joint. The treatment approach varies depending on the severity of the separation, patient factors, and associated injuries. Options may include conservative measures like rest, ice, and physical therapy for milder cases, while more severe separations may require surgical intervention such as AC joint reconstruction or stabilization. The choice of treatment is tailored to each individual’s needs and circumstances.

What non-operative options are available?

Rest and Immobilization: Resting the shoulder and limiting movement to allow the injured ligaments to heal. Immobilization may involve wearing a sling or shoulder brace to stabilize the joint during the initial phase of recovery.

Pain Management: Non-steroidal anti-inflammatory drugs (NSAIDs) or pain relievers may be prescribed to alleviate discomfort and inflammation associated with AC joint separation.

Physical Therapy: Physical therapy plays a central role in the conservative management of AC joint separation. A tailored exercise program is designed to strengthen the muscles surrounding the shoulder joint, improve joint stability, and enhance range of motion. Exercises may include:

• Strengthening Exercises: Targeting the muscles of the shoulder girdle, including the deltoids, rotator cuff muscles, and scapular stabilizers, to improve muscle strength and control.
• Core Strengthening: Incorporating exercises to strengthen the core muscles, including the abdominals and lower back, which play a crucial role in maintaining proper posture and shoulder stability.
• Proprioceptive Training: Engaging in balance and proprioception exercises to improve neuromuscular control and joint proprioception, reducing the risk of recurrent instability episodes and promoting overall shoulder stability.

What operative options are available?

Surgery may be considered for severe cases of AC joint separation, particularly those involving significant ligament disruption or displacement of the joint.

Surgical techniques vary depending on the injury’s specific characteristics but commonly involve stabilizing the AC joint through techniques like open reduction and internal fixation (ORIF), AC joint reconstruction, or ligament repair.

What does rehabilitation look like?

Rehabilitation following AC joint separation aims to restore shoulder function, strength, and range of motion while promoting healing and preventing recurrence of the injury. Physical therapy plays a critical role in the rehabilitation process, with a structured program tailored to the individual’s needs and goals. The rehabilitation program typically progresses through various phases, starting with gentle range of motion exercises and gradually advancing to strengthening and functional activities. Patient education on proper shoulder mechanics, activity modification, and injury prevention strategies is also integral to long-term recovery and shoulder health.

In conclusion, the management of AC joint separation necessitates a comprehensive approach aimed at addressing the underlying injury, alleviating symptoms, and restoring stability and function to the shoulder joint. Conservative measures such as rest, ice, immobilization, and physical therapy are often effective for mild to moderate cases, aiding in pain relief, strengthening the surrounding muscles, and promoting joint healing. In more severe or persistent cases, surgical intervention may be warranted to repair or reconstruct the damaged ligaments and restore proper alignment of the AC joint, thereby optimizing long-term shoulder function and stability.

Dr. Shane J. Nho is a board-certified fellowship trained sports medicine orthopaedic surgeon who specializes in the treatment of AC joint separation. If you believe you are affected by a separated shoulder, schedule a consultation today with our experienced orthopaedic care team.