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ACJ an inside look
Acromion clavicular joint (ACJ) is the connection between your collarbone (clavicle) and shoulder blade. It’s stabilised by 3 major ligaments. It accounts for 40% of all shoulder injuries, 10% occurs in collision sports (e.g lacrosse, ice hockey)
Mechanism of injury
- Direct trauma to the outside shoulder or the joint when the arm is close to the body.
- Fall on outstretched hand or elbow
Different levels of severity of ACJ injury
6 different classifications in total.
Grade 1: ligaments intact: minor injury
Grade 2-3: ligaments are torn and the collarbone is elevated
Grade 4-6: ligaments are torn with varying displacement of the collarbone
Rehabilitation Guidelines
- P.O.L.I.C.E. (Protect, Optimal Loading, Ice, Compression, Elevation)
- Range of motion (ROM); passive, active-assisted, active
- Example; towel slides, pendulum swings, scapula protraction/retraction/ elevation/depression
- Manage soft tissue tightness
- Sleeper stretch for GHJ capsule
- Pectoralis stretches
- Avoid aggravation of injury
- Exercises to avoid; bench press, prone press-ups, shoulder press or dips
- Isometric exercises – ensure multi-angle, submaximal and subpainful
- Closed kinetic – increase load as tolerated, add active arm elevation and rotation
- Transition from closed chain to open chain exercises
- Wall slides
- Low rows
- Punches
- Across body pulls
- Upper cuts
- Abduction with various angles
- Plyometric exercises;
- Med ball toss and catch
- Single arm exercises
- Sport specific exercises
