Have you ever been playing touch rugby, and in your enthusiasm, you zigged when you should have zagged? You lose your footing, fall, and land on your shoulder? Or possibly whilst playing in the surf, you underestimated the big wave that picked you up and dumped you on your head and shoulder? You may have then experienced a nagging pain at the tip of your shoulder which became worse as you tried to lift your arm up to do anything e.g. washing your hair, shoulder exercise at the gym? You may have noticed a lump on the top of your shoulder? If this is the case, it is very possible that you have injured your acromioclavicular (AC) joint in the shoulder.
The AC joint connects the collar bone (clavicle) to the shoulder blade (scapula) forming a point of stability for the shoulder complex. As described above, this injury is commonly seen in contact sports but any direct trauma to this area of the shoulder can result in an AC joint sprain.
The AC joint has numerous ligaments surrounding it that limit the degree of movement, as well as providing it with a great deal of stability. The severity of the injury will depend on the force of the trauma, if the force is great enough, the supporting ligaments can be sprained or even torn which then can only be corrected surgically.
Along with the restricted movement in the AC joint due to the trauma, there is generally also an associated muscular and/or tendinous component that adds to the discomfort, which should also be addressed. Initially the goal is resting (i.e. limiting the aggravating circumstances) and icing to assist in reducing the inflammation in the area. As Chiropractors, we follow this by mobilising the joint to help restore range of movement and deal with any muscle, tendon and/ or ligament pathology that has arisen either from the initial trauma or as a compensation from the altered biomechanics of the injured joint. We also address any joint dysfunction in the neck (cervical spine) and upper back (thoracic spine) which are often associated with this type of injury because of its relation to the shoulder.
This type of injury can go for prolonged periods of time being untreated if the individual cannot recall a specific fall or trauma and they tend to put it down to stress or a hard workout at gym. As such they never fully recover because as soon as they perform any aggravating movement or action, they experience pain. This is because the joint is mechanically restricted and needs to have its movement restored through mobilisation or manipulation.
For a mild sprain of the joint, with regular therapy and rehabilitation, recovery is normally seen from 2 – 4 weeks assuming there are no concomitant conditions and the patient is compliant with home exercises as well as refraining from aggravating circumstances.
If any of this sounds familiar, you may want to schedule an appointment with your Chiropractor or physical therapist to get yourself assessed.
For more information please feel free to contact me.
Dr Warren Jordan
Kings Park Sports Medicine Centre