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