ACROMIO-CLAVICULAR DISORDERS
Background, Mechanism, Signs and Symptoms and Treatment
The acromio-clavicular (A-C) joint is found at the junction of the collar bone (clavicle) and point of the shoulder (acromion). It is held together by a series of strong ligaments which attach the bones and require a large force to disrupt and damage the joint.
MECHANISM OF INJURY (How Does it Happen)
The most common way to injure the A-C joint is a fall onto the point of the shoulder, elbow or outstretched arm. This may occur in contact sports like rugby, football and hockey or other sports like cycling and riding in which falls are common. There are varying degrees of severity depending on the amount of damage to the joint which can be assessed and investigated by your doctor or physiotherapist. Early identification of the level of injury is vital in deciding the course of treatment and ensuring a speedy recovery from the injury.
SIGNS AND SYMPTOMS
The most noticeable feature is a characteristic step deformity near the point of the shoulder. This is usually accompanied by local pain and tenderness (which can be quite intense), swelling of the area and difficulty with certain arm movements like reaching across the body and overhead. Depending on the nature of injury, the symptoms may last for up to 6 weeks; and if problems persist further investigation may be required. As the A-C joint is so closely related with the shoulder joint - it is not uncommon for shoulder joint problems to arise and even upper spinal problems.
TREATMENT
The treatment depends mostly on the severity of the injury therefore it is essential to see a doctor or physiotherapist as soon as possible. Early management of the injury can be important in reducing the severity of the injury and should begin as soon as the injury occurs.
Initially the arm should be rested in a collar and cuff sling with rigid taping to support the injured joint. Ice should be applied in the form of an icepack for 20 minutes then removed and rested for 2 hours. This can continue for the first 24-48 hours. Every attempt should be made to rest the joint and limit the amount of movement in that arm. Modifications at work and home may be necessary, as lifting should be avoided initially.
As previously stated, early medical advice is essential in the determining:-
1. The extent of injury (i.e. is there a fracture?)
2. The nature/classification of injury
3. The appropriate treatment
4. The prognosis - how long the injury will take to heal
5. When to return to sport/work