AC Joint Injury Treatment Adelaide
Dr Arthur Turow, Shoulder SurgeonAn AC joint injury affects the ligaments connecting your collarbone to the shoulder blade. It often happens after a fall directly onto your shoulder or after a sporting collision. Symptoms include pain, swelling and a noticeable bump at the tip of your shoulder.
Dr Arthur Turow assesses and treats AC joint injuries in Adelaide. Treatment depends on the severity of your injury and the activities you’d like to return to. Many injuries improve with rehabilitation, while some require surgery.
Shoulder X-ray showing marked AC joint separation. The of the collarbone sits above the acromion.
In an AC joint injury, the ligaments connecting your collarbone to your shoulder blade are damaged
An injury often happend after a fall or sporting collision, causing pain, swelling &, in more seve injuries, a bump
Many AC joint injuries improve with a sling, pain relief & physio
High-grade injuries with persistent instability may need surgery
Surgery aims to restore stability by repairing or reconstructing the damaged ligaments
Recovery after AC joint surgery takes several months & includes a period in a sling & physio
What is an AC injury?
An AC joint injury involves damage to the ligaments connecting the collarbone (clavicle) to your shoulder blade (scapula). The main ligaments are the (1) AC joint itself and the (2) coracoclavicular ligmants. These ligaments form an important link between the two bones and are responsible for maintaining stability and proper movement of your shoulder.
AC joint injuries are commonly caused by falls or direct impact to your shoulder, such as during contact sports, falls or accidents. The severity of an AC joint injury can range from a mild sprain to a complete dislocation of the joint.
AC Joint Injury Grades
AC joint injuries range from a mild sprain to a complete separation. The Rockwood classification is most commonly used. It describes six grades:
- Grade 1: The AC ligaments are sprained, but the joint remains aligned.
- Grade 2: The AC ligaments are torn and the supporting coracoclavicular ligaments are injured. There may be a small bump.
- Grade 3: Both ligament groups are torn, allowing a more noticeable separation. Many of these injuries can initially be treated without surgery.
- Grades 4 to 6: These involve more substantial displacement or displacement in a different direction. Specialist assessment helps determine the appropriate treatment.
AC Joint Injury Grades
AC joint injuries range from a mild sprain to a complete separation. The Rockwood classification is most commonly used. It describes six grades:
- Grade 1: The AC ligaments are sprained, but the joint remains aligned.
- Grade 2: The AC ligaments are torn and the supporting coracoclavicular ligaments are injured. There may be a small bump.
- Grade 3: Both ligament groups are torn, allowing a more noticeable separation. Many of these injuries can initially be treated without surgery.
- Grades 4 to 6: These involve more substantial displacement or displacement in a different direction. Specialist assessment helps determine the appropriate treatment.
What are the symptoms of an AC injury?
The symptoms of an AC joint injury can vary depending on the severity of the injury. Mild injuries may only cause mild pain and swelling, while more severe injuries can cause significant pain, swelling, and deformity. Other symptoms of an AC joint injury may include:
Limited Range of Motion
Disruptions of the stabilising ligaments of the AC joint can lead to abnormal shoulder blade movement. You may have limited range of motion in the shoulder and find it challenging to raise the arm or perform certain movements without discomfort.
Sensation of Instability
In severe AC joint separations, the shoulder may feel unstable or loose, and the clavicle may appear visibly higher than usual, especially with cross-body and overhead movement.
How Is an AC Joint Injury Diagnosed?
With an AC injury, your AC joint will be painful and swollen. X-rays help assess your joint alignment and identify any associated injuries, for example a clavicle fracture. Dr Turow will ask about how you injured yourself and examine your shoulder, with particular focus on dynamic stability.
Normal AC Joint
There are several ligaments that stabilise the acromioclavicular joint.
AC Joint Injury
In an AC joint injury, the stabilising ligaments get disrupted leading to separation of the joint.
AC Joint Injury Treatment in Adelaide
Treatment Without Surgery
Treatment for an AC joint injury depends on the severity of the injury and your specific circumstances. Many mild to moderate AC joint injuries can be managed without an operation. Treatment includes a sling for comfort, icing, pain relief and temporary changes to your work and exercise schedule.
As your pain settles, physio can help to restore your shoulder movement, strength and dynamic control. A visible bump can remain even when pain and function improve. Its presence alone does not mean that your shoulder needs more treatment.
When Is AC Joint Surgery Considered?
Surgery is reserved for high-grade injuries or when instability continues to limit your everyday activities or sports, despite appropriate rehab.
AC joint stabilisation surgery aims to restore stability by restoring the alignment of your collarbone with the shoulder blade. In this technique, several titanium buttons and strong suture material are used to stabilise your AC joint.
Dr Turow will discuss benefits, risks, alternative treatments and recovery timing with you.
AC Joint Injury Recovery Time
Recovery depends on the severity of your injury, your treatment so far and the activities you’d like to go back to.
Symptoms from a low-grade AC joint injury usually settle over 2-6 weeks, although it can take several months for the shoulder to feel normal again. High energy or high-grade injuries take longer to recover from.
After AC joint reconstruction, you need to allow for several months of recovery. You would usually wear a sling for 4-6 weeks. Your physio would then start a graduated physio with you; initially focussing on range of motion and then strengthening.
Returning to heavy lifting or contact sport takes between 3-4 months. Dr Turow and your physio will guide you during your rehab.
AC Joint Assessment with Dr Arthur Turow
Dr Arthur Turow is an Adelaide orthopaedic surgeon specialising in shoulder and upper limb conditions. He holds FRACS (Orth) and FAOrthA qualifications. He holds staff specialist appointments at the Royal Adelaide Hospital and The Queen Elizabeth Hospital. He also holds a Master of Surgery and is a clinical lecturer with the University of Adelaide.
Your consultation starts with understanding your injury, examination of your shoulder and review of your imaging. Your activity level, work and sporting ambitions are also important considerations. Dr Turow will explain your treatment options and the rehabilitation goals.
Consultations are available in Adelaide CBD and at regional locations across South Australia, including Yorke Peninsula, Gawler and Mt Barker.
Frequently Asked Questions
Does a grade 3 AC joint injury always need surgery?
No. Many grade 3 injuries can be treated without surgery; however, some patients have persistent instability that affects normal shoulder blade movement. This can make it difficult to return to normal shoulder function.
Surgery is reserved for patients that have persistent pain or instability despite dedicated physio; especially when you use your shoulder for heavy manual work or demanding sports.
Dr Turow will assess your shoulder stability and symptoms before discussing the treatment options with you.
Will the bump on my shoulder disappear?
As swelling reduces after your injury the prominence over your shoulder will reduce. A residual bump can frequently remain, even after surgery or complete recovery. Many people regain useful, comfortable shoulder function despite a persistent bump. If you have ongoing pain or difficulty using your shoulder you may need a re-assessment.
Is an AC joint separation the same as a shoulder dislocation?
No. An AC joint injury, or AC joint separation, affects the connection between your collarbone and your shoulder blade. A shoulder dislocation occurs when the ball of your shoulder comes out of its socket. They are different injuries & require different assessment and treatment.