What is the Acromioclavicular Joint?
The acromioclavicular joint is formed by the outer end of the clavicle (collar bone) and the acromion process of the scapular (shoulder blade). The acromion is a bony process which protudes forwards from the upper part of the scapular. This joint forms the highest part of the shoulder.
The two bones are attached by the acromioclavicular ligament. There are several other ligaments which can be of importance in AC joint injuries, including the coracoclavicular (CC) ligament (divided into conoid and trapezoid sections) which joins the clavicle to the coracoid process, another forward protuding part of the scapula, slightly below and to the inside of the acromion.
A third ligament is the coracoacromial ligament which attaches the acromion process to the coracoid process, although it is rarely involved in this type of injury.The most common way of injuring the AC joint is by landing on the shoulder, elbow, or onto an outstretched hand.
Symptoms include:
- Pain at the end of the collar bone
- Pain may feel widespread throughout the shoulder until the initial pain resolves, following this it is more likely to be a very specific site of pain over the joint itself
- Swelling often occurs
- Depending on the extent of the injury a step-deformity may be visible. This is an obvious lump where the joint has been disrupted and is visible on more severe injuries
- Pain on moving the shoulder, especially when trying to raise the arms above shoulder height
AC joint injuries are graded from 1-6 using the Rockwood scale which classifies injuries in relation to the extent of ligament damage and the space between the acromion and clavicle. Grade 1 is a simple sprain to the AC joint, with damage increasing up to grade 6 which involves full rupture of both AC and coracoclavicular ligaments with the clavicle being displaced inferiorly. A step deformity may be apparent with grade 3, 4 & 5 injuries.
Treatment
What can the athlete do?
- Rest and apply ice in the early stage
- Immobilise the shoulder in a sling to ease pain by taking the weight of the arm
- See a Sports Injury Specialist or Doctor
What can a Sports Injury Specialist or Doctor do?
- Tape the joint into the correct position to assist with healing. You may need to be taped for 2-3 weeks
- Apply ultrasound for minor injuries, or TENS for pain relief in more severe cases
- Prescribe Anti-inflammatory (such as ibuprofen) medication to reduce pain and inflammation.
- Advise on rehabilitation exercises
- Surgery if required (usually grades 4-6)
WARNING - If this injury is neglected and allowed to heal out of place this could increase the wear and tear on your joint causing you problems in the future
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