Collision sports, throwing sports and overhead activities which involve overhead and across the body movement of the arm cause injury to ACJ. The ACJ injury which is also known as shoulder separation is one of the most commonly observed shoulder injuries in sports medicine, accounting for 9% of all injuries to the shoulder girdle. The injury which was noted by Hippocrates in the earliest days of medicine yet does not have a definitive non-surgical treatment method. Physical therapy though has proved to be an effective treatment for Grade I-III injuries in a short period while other severe injuries will require longer healing periods.
Acromioclavicular Joint (ACJ) injury
The ACJ is formed at the meeting point of three bones which include: The shoulder blade (Scapula), the collarbone (clavicle) and the arm bone (humerus). The joint gets its name from Acromion, which is the end of the scapula and which meets the clavicle. An ACJ injury involves partial or complete damage to the ligaments that hold the joint together. The overstretching of these ligaments causes separation of the acromion and clavicle. ACJ injury might also be called as ACJ separation or ACJ sprain. The injury is graded from I-VI depending on the severity of the injury. While Grade I-III injuries are common, Grade IV-VI injuries are caused by high impact.
Causes and Symptoms
Separation of the ACJ is caused by overstretching of the ligaments that hold it in place. Contact sports which involve collision such as ice hockey, football, rugby and martial arts are a common cause of the injury. Sports that demand overhead movement of the arm such as swimming and gymnastics might also cause it. For those who do not indulge in sports, ACJ injury might be caused due to a fall on the tip of the shoulder or fall on outstretched hand (FOOSH). Symptoms include pain, swelling or bruising of the shoulder, loss of movement and sometimes even a lump in the shoulder top.
Exercises for Rehabilitation
The following physical therapy exercises can help in recovery from Grade I & II injuries. Before you start with exercises the affected joint needs to be well rested, following a bout of cold therapy. To perform these exercises your shoulder movement should be pain free.
1. Front Shoulder Stretch
Place your injured hand on a doorframe or a wall edge (or any fixed point) above your head and gently turn away from it to achieve a comfortable stretch in your shoulder. Hold this stretch for 8-10 seconds and then return to neutral position. Repeat 3-5 times a day.
To perform abduction, stand with your side facing the wall. Now, place your stretched out arm on the wall with only the back of the wrist and hand touches the wall. Try and push the wall away to build resistance. Hold the position for 8-10 seconds and then return to neutral position.
3. Abduction lateral raise
To perform the exercise you will need a resistance band. Place one end of the band under your foot while you hold the other end in your injured arm. Now, raise your arm straight out till your shoulder level while maintaining good posture. Repeat the exercise 10 times in 3 sets.