There are very things more alarming than seeing the end of your collarbone pop out. To help ease some of your worries, we’ll talk all about how to fix AC joint separation.
I understand it can be a bit daunting. But, I’ll walk you through:
- A home remedy that’s more than just icing your shoulder joint
- Basic exercises that help you get better faster
- When surgery is necessary, and
- Other questions you might have about your separated AC joint
So…
How do you fix an AC joint separation?
First of all, holding off on treatment can worsen your symptoms. So, be sure to get treatment right away. Having said that…
The treatment for shoulder separation will depend on its severity.
Odds are that severe injuries will need surgery (AC joint separation repair).
But, mild cases of shoulder separation will likely fair better with conservative treatment. These include home remedies and exercises that you can do on your own.
We’ll discuss them all but let’s start with conservative treatment.
Home remedy for AC joint separation
RICE (Rest, Ice, Compression, Elevation) was the initial treatment for acute injuries.
But, nowadays, POLICE is gaining traction.
It focuses on a safe and gradual return to activity with gentle exercises. But, it also addresses mild pain during the early stages. Likewise, you can still do the protocol at home.
It means:
- Protection – Rest your AC joint for a few days and avoid activities that make your symptoms worse. You can also use an arm sling.
- Optimal Loading – This essentially means doing light exercises to help stimulate healing. This can be as easy as moving your shoulder up and down, or side to side.
- Ice, Compression, and Elevation – These help control pain and inflammation.
Note that some pain and inflammation are necessary as they’re part of how your body heals itself.
If pain persists, combine the following:
- Icing for 15 minutes
- Compression of your shoulder with a bandage
- Elevate your shoulder above chest level
This should help reduce the swelling while still allowing your shoulder separation to recover.
You can also take pain medication as necessary or as your doctor prescribed.
Let’s move on to exercise.
5 steps to fixing a shoulder separation with exercise
These exercises will safely and gradually get you back to your usual activities. They also help address pain.
All you will need is a stick, a ball, and a sturdy wall.
Step 1: Soft tissue work
Your muscles become stiff after immobilization on a protective sling. This usually happens to the muscles at the front of your trunk and shoulders. The stiffness could also lead to a humpback posture. (3)
This, in turn, sets you up for other complications, like a limited range of motion and muscle spasms.
Loosening up the soft tissues around your shoulder should help:
- Increase blood circulation to the area
- Decrease pain, and
- Promote tissue healing
Here’s how:
- Grab a tennis/lacrosse ball. With your uninvolved hand, roll the ball over your chest.
- Apply light pressure as you go through the entire muscle.
- For the muscles at the back of your shoulder blade, place the ball between your shoulder blade and a sturdy wall.
- Use your body to apply pressure and roll the ball along the muscles of your back.
- Do this for 5 mins or until you feel your muscles loosen up.
Step 2: Shoulder mobilization using a wand
Early mobilization is key to faster recovery. It also addresses the stiffness that happens with immobilization after a shoulder separation.
In turn, this promotes tissue healing, decreases pain, and manages inflammation. (4)
Here’s how:
- Look for a stick that is sturdy and long enough to hold with both of your hands shoulder-width apart.
- Hold the stick in front of your lap. Keep your hands shoulder-distance from each other.
- Lift your arms up to shoulder level or as high as your pain makes it tolerable. Lower it back to the starting position.
- Breathe and repeat 10 times.
Check this out: Top 10 wand exercises for shoulder mobility.
Step 3: Strengthen your shoulder blades with shoulder blade clocks
The previous steps target full motion. This step? It gets your shoulder blades in tip-top shape.
This is crucial because our shoulder blades glide and slide with every arm movement. An AC joint separation compromises this movement, alongside the muscles that control it.
Ergo, strengthening your shoulder blades helps:
- Reduce AC joint stress
- Cut the demand on your rotator cuffs, and (5)
- Promote proper shoulder biomechanics
Here’s how:
- Stand at arm’s length in front of a wall.
- Raise your involved arm in front of you and place your palm on the wall.
- With your palms on the wall, raise and lower your shoulders to the 12 and 6 o’clock positions. Repeat 10 times.
- Push your shoulder blade away from your spine and then bring it back, mimicking the 3 and 9 o’clock positions. Repeat 10 times.
Step 4: Strengthen your rotator cuff with isometric contractions
Your rotator cuffs are the primary stabilizers of your arm during movement. Pain and immobilization weaken and inhibit them. (6)
Incorporating strengthening exercises into your routine helps prevent shoulder instability and curb apprehension.
Here’s how:
- Stand facing the corner edge of a wall. Bend the elbow on your injured side to 90 degrees and make a fist.
- For your external rotators, push the outer part of your fist into the wall.
- For your internal rotators, push the inner part of your fist into the wall.
- You should be feeling the muscles behind your shoulder blades contract. Make sure to push only to the point where the pain isn’t too painful.
- Hold the contractions for 10 seconds; repeat 10 times.
Step 5: Using the shoulder alphabet to improve proprioception
Proprioception is our body’s ability to sense its position and location. It’s how you can still pinpoint where your arms are even with your eyes closed.
But, a shoulder separation also compromises the joint’s proprioception. (7)
Thus, training your proprioceptive ability also helps prevent re-injury.
Here’s how:
- First, you will need a volleyball (or any similar-sized ball)
- Lightly press the ball between your palm and a wall. Make sure your arm is in front of you and your elbow is straight.
- Roll the ball as if you’re spelling your name or doing the whole alphabet.
- Repeat twice.
When should I consider shoulder surgery?
Your doctor or physical therapist will recommend surgery if your shoulder joint injury is severe.
Now, you might be asking:
What exactly is a “severe” AC joint separation?
Short answer: The Rockwood Classification says there are 6 types of shoulder separations. Type I being the mildest; type VI being the worst.
- Types I and II are mild shoulder separation because there’s relatively less damage to your ligaments and muscles.
- Types IV, V, and VI are severe. Here, your AC ligament and AC joint are fully compromised. Your CC ligament will be partially or completely torn. Muscle detachment is also highly likely.
- Type III is the in-between. Although the injury comes with severe pain, you will only need conservative treatment if your activities don’t put a heavy strain on your shoulder. Otherwise, like with athletes and other jobs with constant shoulder stress, surgery might be necessary.
Your doctor will do a physical exam and a slew of imaging tests to determine the severity. These imaging tests include X-rays, MRIs, and ultrasound.
What are the results of AC joint surgery?
The type of surgery you will have partly depends on your condition. Another factor is the medical opinion and expertise of your surgeon.
In any case, most patients (nearly 100%) who go through surgery are able to get their normal motion back and return to their previous levels of activity.
Here are a couple of surgical procedures and their success rates for your peace of mind:
- The Weaver-Dunn procedure showed 94% of patients had good clinical results. (9)
- Surgery using an artificial ligament found 82% of its patients had good stabilization even 55 months after the operation. (10)
FAQs:
Can an AC separation heal on its own?
That depends on the severity of your condition. Remember: the AC joint ligaments lose their potential to heal after three weeks following injury. (11)
With that short of a period, it’s safe to assume that Type I AC separation can heal on its own with rest and ice. Any more severe and it will be best to get checked by a healthcare professional so treatment can begin immediately.
Will a shoulder brace help with my separated shoulder?
Yes, a shoulder brace can help your recovery.
By providing extra support and stabilization, it assists in keeping your entire shoulder in place. This, then, allows your ligaments to heal.
A shoulder brace also reduces the gap between separated joints. Thus, helping manage any associated shoulder deformity.
Conclusion
AC joint separations are tough to deal with. We hope that this article can help you with your ac joint problem. Remember that this is meant to be a guide; not a medical consult. It is still best to get your shoulder checked by your trusted healthcare professional.
Resources:
- Warth, Ryan J et al. “Acromioclavicular joint separations.” Current reviews in musculoskeletal medicine vol. 6,1 (2013): 71-8. doi: 10.1007/s12178-012-9144-9
- Dhillon, Himmat et al. “Current Concepts in Sports Injury Rehabilitation.” Indian journal of orthopaedics vol. 51,5 (2017): 529-536. doi: 10.4103/ortho.IJOrtho_226_17
- Alizadehkhaiyat, Omid et al. “POSTURAL ALTERATIONS IN PATIENTS WITH SUBACROMIAL IMPINGEMENT SYNDROME.” International journal of sports physical therapy vol. 12,7 (2017): 1111-1120. doi: 10.26603/ijspt20171111
- Cote, Mark P et al. “Rehabilitation of acromioclavicular joint separations: operative and nonoperative considerations.” Clinics in sports medicine vol. 29,2 (2010): 213-28, vii. DOI: 10.1016/j.csm.2009.12.002
- McMullen, J, and T L Uhl. “A kinetic chain approach for shoulder rehabilitation.” Journal of athletic training vol. 35,3 (2000): 329-37. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1323395/
- Ben-Yishay, A et al. “Pain inhibition of shoulder strength in patients with impingement syndrome.” Orthopedics vol. 17,8 (1994): 685-8 https://pubmed.ncbi.nlm.nih.gov/7971520/
- Ager, Amanda L et al. “Proprioception: How is it affected by shoulder pain? A systematic review.” Journal of hand therapy : official journal of the American Society of Hand Therapists vol. 33,4 (2020): 507-516. DOI: 10.1016/j.jht.2019.06.002
- Sirin, Evrim et al. “Acromioclavicular joint injuries: diagnosis, classification and ligamentoplasty procedures.” EFORT open reviews vol. 3,7 426-433. 17 Jul. 2018, doi: 10.1302/2058-5241.3.170027
- Millett, Peter J et al. “Acromioclavicular joint reconstruction with coracoacromial ligament transfer using the docking technique.” BMC musculoskeletal disorders vol. 10 6. 14 Jan. 2009, DOI: 10.1186/1471-2474-10-6
- Jeon, In-Ho et al. “Chronic acromioclavicular separation: the medium term results of coracoclavicular ligament reconstruction using braided polyester prosthetic ligament.” Injury vol. 38,11 (2007): 1247-53. DOI: 10.1016/j.injury.2007.05.019
- Nolte, Philip C et al. “Optimal Management of Acromioclavicular Dislocation: Current Perspectives.” Orthopedic research and reviews vol. 12 27-44. 5 Mar. 2020, doi: 10.2147/ORR.S218991