Acromioclavicular Separation

Definition:
A 'separated shoulder' (also known as 'acromioclavicular separation', 'AC joint separation', 'AC separation'), is a common injury to the acromioclavicular joint. This is not to be confused with shoulder dislocation which occurs when the humerus separates from the scapula at the glenohumeral joint. The AC joint is located at the distal end of the clavicle, known as the acromial end, and attaches to the acromion of the scapula. Although this is part of the shoulder, a dislocation and a separation are completely different. Acromioclavicular separation occurs as a result of a downward force being applied to the superior part of the acromion, either by something striking the top of the acromion or by falling directly on it. The injury is more likely to occur if the shoulder is struck with the hand outstretched. Despite the scapula pulling on the clavicle during impact, the clavicle remains in its general fixed position because of the sternoclavicular joint ligaments. The trauma to the shoulder affects the ligaments holding the two bones, the scapula and the clavicle together. This injury does not always involve bone fractures; however if the impact to the shoulder is severe, fractures may occur. There are four types of soft tissue disruptions that may cause acromioclavicular separation: * The conoid and trapezoid ligaments may tear at any location * The lateral clavicle may ride upward after being avulsed from its periosteum * The acromioclavicular ligaments may be torn * The conoid-trapezoid ligament origin may avulse from the coracoid

Symptoms
  • Pain in the front of the shoulder
  • Point tender to the AC/clavicle joint
  • Pain with overhead shoulder movements
  • Possible bump on the top of the shoulder
Causes
  • Direct blow to the top of the shoulder
  • Fall on an outstretched hand
  • Fall on the tip of the shoulder
Treatment
  • Period of sling use for immobilization
  • Stretching and shoulder ROM exercises
  • Posture program
  • Strengthening shoulder stabilizers
Acromioclavicular Separation Phase I

Purchase Phase

  • Passive Shoulder Internal Rotation
  • Armpit To Wall

  • Foam Wedge In Flexion
  • Foam Wedge In Abduction

  • Passive Shoulder Abduction
  • Thoracic Stretch III

  • T Band Wall Push W ER
  • Standing Posture

  • Sitting Posture

Acromioclavicular Separation Phase II

Purchase Phase

  • Wall Slides
  • Prone Rotator Cuff Circuit

  • Superman Holds

  • Shoulder Ext Rot Scap Plane 90 Abd
  • Push Up Hold Top
  • Down Dog

Acromioclavicular Separation Phase III

Purchase Phase

  • Push Ups
  • Hummers

  • Sumo Flies 3 Positions
  • Wall Slides

  • Prone Rows
  • Single Arm Push Up Holds

  • Push Up Hand Fire