AC JOINT INJURY
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The acromio-clavicular (or AC) joint connects the collarbone and the shoulder blade and is essentially what joins your arm to your body.
It is injured with a blow on the point of the shoulder, either contacting an opposition player or the ground.
It is immediately painful and tender to touch on the tip of the shoulder. There may be a bump you can see and feel.
The AC Joint moves with all movements of your arm, so pretty much everything will hurt initially, particularly hands-above-head positions.
It is diagnosed by reproducing the pain, by pushing on the joint, as well as pain with taking the arm across the front of the body. Another good test is to reproduce pain with linking your fingers and pulling apart.
An AC joint injury is an injury of the ligaments. Ligaments are the bits of rope-like tissue that hold our joints together. Ligaments tolerate 4% strain (stretch) before fibres start to tear. Take them to 8% strain and they will rupture.
We grade ligament injuries 1 - 3. For AC joint injuries we further classify them into Types I – V.
Type I correlates with a Grade 1 ligament injury. Type II correlates with a Grade 2 ligament injury. Type III, IV, & V correlate with increasing severity of Grade 3 ligament ruptures. Type III may require surgical repair. Type IV & V definitely require surgical repair.
For Type I and II injuries, initial management is:
Ice regularly for pain relief.
Take anti-inflammatories regularly for a few days.
When the pain allows, try and get the arm moving rather than letting it stiffen up. Lift the arm above your head and behind your back, and roll your shoulders.
When the pain allows, you can return to non-contact training and ball work.
When you return to contact you will feel more comfortable with the shoulder strapped and/or wearing shoulder pads.
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