What is AC joint separation? Do I need surgery for this?

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www.PTcares.com


 Recently a friend of mine had a falling accident in a playground and was Diagnosed as "AC joint separation". She reached out to me and asked the above questions. I spent time chatting online and I realized she had not clue what was going on and what to do about it. I decided to share some information here in case you need some help.

What is AC joint?


 The acromioclavicular joint, or AC joint is a joint connecting the acromion and the clavicle as showed in the following picture. 

What is AC joint's function?

Along with other ligaments, It stabilizes the shoulder girdle and maintain appropriate muscle tone of the neck, shoulder and para-scapular muscles. 


What happened during the injury?

When you fell, you landed on the shoulder and directly hit the acromion of the scapula and increased the shear force to separate the AC joint. Sometimes the violence might be strong enough to separate the coracoclavicular ligament, which is also very important. The surgeons would like to assess this ligament's integrity before offering surgery or not.

 There are 6 classes of AC joint separation.
Why do you need to know about this?
Grade 4-6 requires surgery.
Image result for ac joint separation

 Grade 1-3 can be treated conservatively without surgery as showed on pictures on the right.

 The ligaments might still have a chance to reattach together and get back to full function.

 Tip: Ask your doctor about the severity of the injury and classification of the separation. You might need to come back for a second look in 1-2 weeks with or without update of the X ray.

 As indicated on the picture of Grade 3 AC joint separation, the coracocalvicular ligament might also be separated and the weight of the scapula and upper limb might be pulled down by gravity without support of the ligaments. You neck and upper back and the shoulder muscles might get into spasm and pain due to the pulling of the weight.  Your shoulder might be placed in a sling to decrease that pulling and discomfort.

 There is another treatment option to decrease the discomfort of the shoulder.
Check out the Strapping and taping the AC joint of the shoulder. As a doctor of physical therapist, I do see the benefits of taping for my clients with this diagnosis. I highly recommend the Strapping and taping the AC joint approach.
Pros of taping:
1.direct support between the clavicle and upper arm, decrease the loading of the AC joint.
2.Taping increases the proprioception input of the skin and decreases the compensatory motions of the shoulder girdle.
3. No need to place the arm in internal rotated position and elbow flexion position in a sling for days. So better sleeping!

Cons of taping:
1. Potential skin irritation after prolonged use; Swelling and injury might make it hard to tolerate.
2. Patient might feel overconfident with the taping pain and overdo for a lot motions and ended up with more swelling

No sure which grade of AC joint separation you are in ?
Go to PTcares.com and ask your questions. 
All messages are HIPAA compliant, powered by G suite service with BAA signed.

Now you understand the anatomy and expectation for acute management to decrease your pain and stress. But what to do next? See the next article of key treatment of the shoulder and neck after AC joint injury.


*Disclaimer:*The information contained herein is compiled from a variety of sources for educational purpose. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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