Why Is Acromicoclavicular Joint Disorder Mostly Seen in Sports Players?
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Acromioclavicular (AC) Joint Disorders in Sports Players - Causes, Symptoms, and Treatment.

Published on Oct 28, 2022 and last reviewed on May 30, 2023   -  4 min read


Acromioclavicular (AC) joint disorders in sports players include separated shoulders or ligament tears. This article explains this condition in detail.


Acromioclavicular (AC) joint disorders in sports players can be divided into acute injuries, degenerative conditions, repetitive strain injuries, and various other conditions. Acute AC joint injury is sometimes called a sprain or "separated" shoulder and can be diagnosed with swelling, focal tenderness, and deformity. Diagnosing AC joint disorders due to overuse, inflammation, or chronic degeneration may be more difficult, especially if the patient has concomitant shoulder problems.

A separated shoulder occurs due to the tearing of the ligaments between the collarbone, known as the clavicle, and a section of the shoulder blade called an acromion. This tear causes the mutual connection between the collarbone and shoulder blade to loosen. Thus, they either get separated or dislocated from each other. This type of injury does not usually cause damage to the main ball-and-socket joint of the shoulder. Any individual can get affected by this condition. There is no difference based on age, physical health, ethnic background, or fitness level.

How Is It Caused?

The prevalence of AC joint pain has been reported to be between 0.5 to 2.9 per 1000 people per year. The most common cause of pain or swelling is an injury from catching oneself on an outstretched arm. Most cases reported with shoulder separation are because of a direct fall onto the shoulder with enough force, which can tear the ligaments. These injuries are more commonly observed in young people as they are frequently associated with collision sports like football, hockey, etc.

Various other causes of injury to the joint are as follows:

What Are The Signs And Symptoms Of A Separated Shoulder?

The patient who has undergone AC injury can experience the following:

  • Pain at the top side of the shoulder.

  • Presence of bump or swelling on the top of the shoulder and near the end of the collarbone.

  • The shoulder blade tends to move in a downward direction because of the weight of the arm and torn ligaments. This can lead to the lifting of the top end of the collarbone.

How Can It Be Diagnosed?

When you visit your physician, you will be asked about your personal history, family history, medical history, and the signs and symptoms you are experiencing. Following this, a physical examination will focus on the affected shoulder. Your doctor may ask you to undergo various tests to confirm the diagnosis and decide on the treatment plan, which includes X-rays, ultrasounds, and MRIs (magnetic resonance imaging). Also, the patient may be instructed to hold a weight in hand while performing these tests to visualize the injury more clearly in the images.

After all these examinations and tests, the doctor can diagnose the severity of the shoulder separation using a scale called the Rockwood classification of AC joint injuries. This scale ranges from type I to VI injuries from "injury limited to an AC ligament sprain; joint still in place to severe ligament detachment and joint dislocation injuries," respectively. This staging helps in accurate diagnosis and treatment plan, including guiding the patient about the time taken for treatment and prognosis.

How Can It Be Treated?

Most people will recover from this condition within two to 12 weeks without surgery.

Non-surgical Treatments: The various non-surgical treatments which can be done on these patients are as the following:

  • A sling can keep the shoulder in place during the healing period.

  • Ice packs and medicated drugs like Ibuprofen, Aspirin, Naproxen, or Acetaminophen can be used to reduce pain.

  • Strengthening the muscles and ligaments of the shoulder can be done with the help of physical therapy or an exercise session after the healing period. Getting the physician's consent before initiating a rehabilitation program is important.

  • The patient should avoid lifting heavy objects for eight to 12 weeks after healing the injury.

Surgical Treatments: Surgery may be indicated in more serious cases like type IV, V, or VI injuries on the Rockwood scale or after the non-surgical treatments have not shown improvement. The symptoms of more serious injuries include when the fingers become cold or numb, weakened arm muscles, or severe shoulder deformity.

The surgical treatments that can be considered are as the following:

  • Shaving the end of the collarbone. This will help in preventing it from rubbing against the shoulder blade.

  • Reattachment of torn ligaments to the underside of the collarbone.

What Are The Complications Associated With This Condition?

Although most people recover and regain the complete function of the injured shoulder, some people may experience a bump or other deformity. They can also have continuous pain, even in cases with mild shoulder separation. This can be due to the rubbing of bones against each other, arthritis, or damage to the cartilage, which acts as a cushion between the bones of the shoulder joint. You should consult your physician or specialist if you have recurring signs and symptoms or face any of the mentioned complications.

How Can It Be Prevented?

There is no sure way to prevent shoulder separation. However, being aware of the factors that can cause shoulder separation can help prevent it.

These factors have been mentioned below:

  • Old age.

  • Repetitive motions of the shoulder.

  • Manual labor causes more force on the shoulders.

  • Accidents

  • Falls.

  • Overuse or straining of the shoulders, especially in older adults.

  • Participation in collision sports.


Acromioclavicular (AC) joint disorder, which is more common in sports players, is the separation of shoulders. It can be managed conservatively and surgically, depending on the severity of the condition. Most cases heal with conservative management. The prognosis is good in most cases. Early management can assist in preventing any complications. The state is mainly associated with sports injuries, accidents, or falls, and proper rest and physiotherapy can help improve healing.

Frequently Asked Questions


What Is an Illness of the Acromioclavicular Joint?

Acromioclavicular joint osteoarthritis (inflammation or swelling of one or more joints), also known as AC joint arthrosis, is most common in middle-aged persons. It appears when the AC joint's cartilage begins to wear down. Usually, this illness causes discomfort that restricts arm movements. Primary degenerative, inflammatory, posttraumatic, and septic arthritis are some of the pathologic mechanisms that can cause this illness, which is the most prevalent of the acromioclavicular joint. The clinical picture is further complicated by the patients' frequent nonspecific complaints of neck, shoulder, and arm discomfort.


Is Degeneration of the Acromioclavicular (AC) Joint Similar to Arthritis?

Yes, degeneration of the acromioclavicular joint is the most similar kind of arthritis. Anterior or superior shoulder discomfort is frequently brought on by the degeneration of the acromioclavicular (AC) joint, especially during overhead and cross-body exercises. The fibrocartilaginous disc that cushions the joints most frequently degenerates in middle-aged people, which is when this most frequently happens. Traumatic injuries or arthritis are the two main causes of AC joint discomfort. Several disorders, collectively known as arthritis, lead to joint deterioration and inflammation.


Can an Acromioclavicular (AC) Joint Heal Without Surgery?

About 50 percent of patients will heal completely without surgery, and they can resume their sporting activities more quickly than if they underwent surgical repair. About 25 percent of individuals may experience acceptable but prolonged, low-grade symptoms that could impair job or athletic performance. Treatment options for Grade-III serious injuries include both non-operative and surgical methods. A course of physiotherapy is administered after two to three weeks of immobilization in a splint as part of non-operative treatment.


How Is an Acromioclavicular (AC) Joint in the Shoulder Fixed?

Typically, reconstructive shoulder surgery will last two hours. The collarbone could need to be moved in the AC joint, and torn ligaments need to be stitched together. Normally, general anesthesia is administered; however, certain patients may also have an interscalene block (to do surgery on the upper arm, shoulder, or neck, the brachial plexus is anesthetized at the level of the nerve roots), a regional anesthetic administered above the collarbone. Over the bony protrusion on the top of the shoulder, there is a two-inch incision created. Sutures are used to repair torn ligaments that surround the acromioclavicular joint. The ligaments can be stitched back into place to help retain the collarbone in place and tighten the shoulder. The collarbone may need to be held in place while the ligaments repair using a screw or strong sutures. After the wound is stitched up, patients are sent to the recovery area.


Can Acromioclavicular (AC) Joint Ever Recover?

After a type I acromioclavicular joint injury, most persons may resume their regular activities in three to two weeks. Overhand athletes could need two to three weeks to go back to the full exercise. It can take four to six weeks to recover fully. Type I wounds often recover fully without a higher risk of re-injury. Compared to type I, Type II injuries typically result in more pain and swelling. The first course of therapy may consist of rest, ice, painkillers, and three to seven days of splint immobilization of the shoulder. Stretching and range-of-motion exercises can be started as soon as they are bearable.


Why Is the Joint Acromioclavicular (AC) Not Healing?

The shoulder joint has probably been injured in addition to the AC joint, which is the most likely cause of a poor recovery. This is a relatively frequent issue, and an orthopedic appointment is necessary if shoulder pain lasts more than a few weeks to assess the likelihood of other injuries. Most patients with AC joint injuries may feel better a few days or a week after the incident, but the AC ligaments may not entirely recover for at least six weeks.


What Medicines Are Effective for Acromioclavicular Joint Pain?

The following drugs can treat acromioclavicular osteoarthritis symptoms and reduce their development: 
- Oral painkillers like Acetaminophen, the main component in Tylenol, and other painkillers have few adverse effects and are effective at reducing pain.
- Non-steroidal anti-inflammatory medications are taken orally (NSAIDs). 
- Aspirin, Ibuprofen, Naproxen, or COX-2 inhibitors are anti-inflammatory drugs that may lessen discomfort, swelling, and inflammation brought on by osteoarthritis of the AC joint. 
- Creams and lotions. Topical treatments are administered directly to the skin over the affected joint and come in creams, sprays, gels, and patches. Topical drugs come in wide different varieties.


Is Acromioclavicular (AC) Joints Similar to Rotator Cuffs?

No, the AC joint is not similar to rotator cuffs. Because the upper arm bone's head is covered by the rotator cuff, which also connects it to the shoulder blade, the acromion and clavicle, which comprise a component of the scapula, meet at the AC joint. Tough connective tissues function as tethers to hold the bones in place.


Does Physical Therapy Help With Arthritis of The Acromioclavicular (AC) Joint?

Physical therapists can treat mild cases. Physical treatment may be followed by surgery in more severe situations. Because the joint is repeatedly under too much stress, AC joint damage from strain develops over time. The extent of the AC joint damage determines how long one will need physical treatment. Type I and Type II wounds could take two to three weeks to heal completely. Physical therapy might take eight to twelve weeks if surgery is required to fix the AC joint separation.


What Can Heal An Acromioclavicular (AC) Joint Quickly?

- Rest will benefit the healing of the shoulder. 
- Using a splint is possible to protect the shoulder and keep the joint in an ideal healing posture. 
- Cold packs can be applied to ease pain and reduce swelling. 
- One can use either over-the-counter or prescription painkillers. One can work both arms and shoulders exercises.


How Can Acromioclavicular (AC) Joints Loosen?

Dislocation of the clavicle from the acromion causes an AC joint separation, often known as a shoulder separation. This injury is frequently brought on by a hit to the shoulder or a fall in which the person lands squarely on their arm or shoulder. Contact sports like football and hockey are the most frequent causes of AC joint separations. An acromioclavicular joint injury's severity determines which supporting tissues are damaged and how badly. When the coracoclavicular ligaments are torn, the entire shoulder joint is affected, making a dislocation more difficult. Tearing of the acromioclavicular ligament alone is rarely a major injury.


How Should An Acromioclavicular (AC) Joint Be Massaged?

Although it comes after the osteopath's role, massage is essential to the procedure. Massage can relieve discomfort, reduce swelling, and condition the muscles around the incision once the shoulder has been reset or determined to have no dislocation. The muscles would extend with deep tissue massage, increasing the instability of the joint. A superficial massage might be utilized to lessen the swelling's inflammatory effects. Ask the doctor to recommend a physiotherapist.


How Severe Is an Acromioclavicular (AC) Joint Sprain?

An AC joint sprain can range in severity from a minor injury grade one to a serious injury grade six. The AC ligament is exclusively sprained in type I damage, whereas it is ripped in type II injury. The AC and Coracoclavicular ligament (CC) are ruptured in type III, although the distal clavicle is only partially displaced. In type IV, the distal clavicle is displaced posteriorly, and both ligaments are ruptured. Extreme instability of the AC joint is caused by Type V damage, which involves tearing the AC and CC ligaments and the origin and insertion of the deltoid and trapezius muscles. The distal clavicle's inferior displacement into the subcoracoid position leads to type VI injuries.

Last reviewed at:
30 May 2023  -  4 min read




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