Acromioclavicular (AC) sprains, commonly known as separated shoulders, are a frequent athletic injury this time of year.
The AC joint is where the clavicle (or collarbone) meets the scapula (or shoulder blade) and is held together by ligaments.
When these ligaments are injured or torn, a sprain occurs.
AC sprains most commonly occur when an athlete lands directly on the shoulder.
Symptoms include pain, especially when bringing the injured arm across the front of the body, and a lump may be present on the top of the shoulder.
Bruising and swelling may also be present. X-rays are needed to rule out a fracture, but they also help doctors to see the amount of widening of the joint and if the collar bone is raised up.
AC sprains are then graded by the amount of widening and elevation of the collar bone seen on the X-ray.
There are six grades of sprains:
Grade one sprains show minimal widening and the collar bone has not risen in the joint.
Grade two sprains show widening and the collar bone sitting up slightly.
Grade three sprains show widening and the collar bone elevated at a greater level than grade two.
Grades four through six also exist, but are rare and often require surgical intervention.
Initial treatment for an AC injury includes rest, ice and a sling for comfort. The athlete should prop up the arm when sleeping.
Anti-inflammatory medications can be taken to help with the pain and discomfort.
Therapy can begin immediately and may include gentle range of motion of the fingers, wrist and elbow to prevent stiffness of those joints. As pain levels improve, strengthening and range of motion exercises for the shoulder should be incorporated.
Athletes should work with a certified athletic trainer or therapist to help ensure that the correct exercises are completed.
A good indication that the AC injury has healed enough to return to normal activities is when the athlete experiences pain-free full range of motion.
Full range of motion includes bringing the arm across the body and having the same strength equal to the other side.
Once cleared to return to normal activity, a pad worn over the joint should be used to prevent pain and re-injury.
For more information about AC sprains, please contact Susquehanna Health Sports Medicine at 1-800-321-2WIN.
Stephanie Erlandson is a Certified Athletic Trainer for Susquehanna Health Sports Medicine.