Physical Therapy for an AC Joint Sprain

An AC joint sprain typically occurs due to a sudden fall on the shoulder that can push the shoulder blade away from the collarbone, straining or tearing the ligaments of the AC joint. Physical therapy is the first line of treatment for AC joint sprains and is highly effective in restoring shoulder mobility, strength, and function following an AC injury.

The AC joint, or acromioclavicular joint, is a joint in the shoulder where the clavicle (collarbone) and the acromion of the scapula (shoulder blade) meet.  The AC joint plays a key role in stabilizing the shoulder, maintaining the position of the shoulder, and allowing for efficient upper limb mechanics, scapular movement, and shoulder control, motion, and strength

An AC joint sprain can occur when a strain or tear occurs in the ligaments of the AC joint, where the shoulder blade attaches to the collarbone. An AC joint sprain, or shoulder separation, typically occurs due to a sudden fall on the shoulder that can push the shoulder blade away from the collarbone due to landing on the outside of the shoulder or onto an outstretched hand. This can result from a tackle while playing football, a bicyclist crashing over the handlebars, injury in a car accident, or from an individual tripping and falling from a ladder or on the stairs.

Common symptoms of an AC joint sprain include: 

• Shoulder pain and swelling over the AC joint

• Pain that radiates into the neck and shoulder

• Loss of shoulder strength and mobility

• Visible bump above the shoulder

• Pain when lying on the involved side

• Popping sound or catching sensation with movement of the shoulder

• Discomfort with daily activities that stress the AC joint like lifting objects overhead, reaching across the body, or carrying heavy objects by your side

• Elevation of the collarbone depending on severity of injury

Physical therapy is the first line of treatment for AC Joint sprains and is highly effective in restoring shoulder mobility, strength, and function following an AC injury.

Physical therapy for an AC joint sprain can include:

• Pain and swelling management using ice and heat

• Range of motion exercises to gently restore normal movement in the shoulder joint. A physical therapist guides the patient through passive and active ROM exercises, balancing joint protection and optimal motion restoration. 

• Manual therapy involving hands-on joint mobilizations to gently move the shoulder joint and surrounding muscles to improve flexibility and mobility.

• Strength training of the muscles of the shoulder, elbow, and upper back, all of which work together to coordinate upper-body movement. The physical therapist focuses on balancing the strength of all upper-body muscles to ensure efficient movement of the shoulder with a particular focus on scapular stabilizing muscles to ensure proper positioning of the scapulohumeral complex.

• Functional training, particularly engaging in overhead lifting and moving the arm across the body, which are activities that place significant stress on the AC joint.