AC Separation Treatment

Nonsurgical Treatment for AC Separation

Nonsurgical treatments, such as a sling, cold packs, and medications can often help manage the pain that results from a grade 1 or grade 2 acromioclavicular (AC) joint separation in the shoulder. Grade 3 separations, however, are a bit more complicated.

Many studies show no difference between patients treated with surgery versus conservative treatment. Even with surgery, a bump may still be present where the separation occurred.

Over time, the AC joint may become arthritic and painful. For some people, this process may take several years to develop, but for others, it may happen within one or two years. If this happens, and nonsurgical treatments are unsuccessful, your doctor may recommend surgery.

Surgical Treatment for AC Separation

Surgery may be considered if your pain persists or if the deformity in the shoulder is severe. The goal of surgery is to repair severe grade 3 AC separations. This is especially common in treating high-level throwing athletes.

Surgery is usually done through a four-inch incision over the AC joint. The orthopedic surgeon starts by putting the joint into its correct position. To keep the clavicle in place while the ligaments heal your orthopedic surgeon will use some type of fixation that could include:

• A screw that is removed 6-8 weeks later
• Stitches or sutures
• Surgical tape

Rehabilitation

The shoulder will require rehabilitation to restore and rebuild motion, strength, and flexibility, whether it was treated conservatively or with surgery.

If you don’t need surgery, range-of-motion exercises should be started as pain eases, followed by a program of strengthening. Gradually, the program will advance to include strength exercises for the rotator cuff and shoulder blade muscles. Full recovery can take anywhere from 6 to 12 weeks depending on the grade of your separation.

If you had surgery, you may need to wear a sling to protect and support the shoulder for a few days. In the beginning, your physical therapist will start by having you focus on controlling the pain and swelling through a variety of methods, which may include massage and ice and/or electrical stimulation.

Passive, range-of-motion exercises will come next, followed by active therapy, and then active strengthening.

• Passive exercises improve shoulder joint range of motion while keeping the muscles relaxed.
• Active exercises require the use of your own muscle power.
• Active strengthening exercises focus on improving strength and control of the rotator cuff muscles and the muscles around the shoulder blade.

Recovery from shoulder surgery can take some time. A successful outcome will require patience and diligence when it comes to your therapy program.

Our state-of-the-art physical therapy facilities and experienced physical therapists can help patients recover from injuries and often prevent a more serious injury from occurring. By working with our orthopedic specialists your physical therapist will create a plan that is designed specifically for you.

You can learn more by downloading our educational document A Patient’s Guide to Acromioclavicular Joint Separation.  

Sources:

https://orthoinfo.aaos.org/en/diseases--conditions/shoulder-separation