Acromioclavicular
joint injuries
What is a ACJ injury?
An ACJ (Acromioclavicular Joint) Separation is an injury where the clavicle (collarbone) separates from the acromion (part of the shoulder blade), disrupting the ligaments that hold these bones together.
Types of ACJ Separation:
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Grade I: Mild sprain of the AC ligament without significant separation.
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Grade II: Partial tear of the AC ligament with some separation.
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Grade III: Complete tear of the AC and coracoclavicular (CC) ligaments, causing noticeable separation.
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Grade IV-VI: More severe, involving displacement of the clavicle, often requiring surgical intervention.
Mechanism of Injury:
ACJ separation typically occurs due to a direct blow to the shoulder, such as a fall onto the shoulder or impact during contact sports. This force drives the acromion downward, causing the clavicle to detach from the joint.
Symptoms
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Pain: Localised at the top of the shoulder, especially when lifting the arm.
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Swelling and Bruising: Visible around the joint.
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Visible Deformity: A bump or step-off at the top of the shoulder, particularly in higher-grade injuries.
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Weakness: Difficulty lifting or moving the arm.
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Instability: Feeling of looseness or instability in the shoulder.
Treatment
Immediate Treatment:
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Rest and Ice: To reduce pain and swelling.
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Sling: Immobilisation to support the shoulder and minimise movement.
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Pain Relief: Over-the-counter medications like paracetamol or ibuprofen.
Clinical Treatment:
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Physiotherapy: Focuses on restoring strength and range of motion, particularly in the rotator cuff and scapular stabilisers.
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Manual Therapy: Mobilisation and soft tissue techniques to reduce pain and improve joint mobility.
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Taping or Bracing: To support the joint during healing.
Surgical Treatment:
For severe separations (Grade III and above), surgical repair may be needed. This often involves reconstructing the damaged ligaments. Post-surgery, rehabilitation in the clinic will include a structured physiotherapy programme to restore shoulder function and strength.
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