The ACJ or acromio-clavicular joint is the joint at the top of your shoulder that connects your collarbone to your shoulder blade. This is quite a commonly injured joint, and generally is caused by a fall onto the point of your shoulder, or by a force directly onto the shoulder like in a rugby tackle. Injuries to this joint can range from the very mild to complete ruptures of all the ligaments. Your physio will do a few tests in the physical examination, and have a feel around your shoulder to diagnose this problem. They may also send you for an Xray to confirm the diagnosis and exclude any fractures. All but the most severe of ACJ injuries are treated conservatively with rest, physiotherapy and pain relief. Sometimes you may wear a sling for a short period to help with your pain. Physiotherapy will initially aim to improve your range of movement and decrease your pain. Once you can move your arm freely you will need to do some strengthening exercises before you return to sport. Recovery can take anywhere from 3-12 weeks depending on the severity of your injury.
The ACJ can also be affected by arthritis in the middle aged to older patient. This tends to be of gradual onset and may make movements of the shoulder painful. You may have swelling and the joint will be tender to touch. An Xray will help with the diagnosis of this problem. ACJ arthritis is generally caused by overuse, but if you have had a severe injury in the past this is likely to contribute to early onset of this problem. Physiotherapy can help to increase your range of movement and decrease your pain. They will also advise you on appropriate exercises to improve your movement and strength. You may also benefit from taking anti-inflammatory medication, or having an injection into the joint to decrease pain and inflammation. There are surgical options for when the pain does not improve with conservative measures, and the arthritis is severe.
Another problem that can occur to the ACJ is an overuse injury often caused by heavy weightlifting. This is called clavicular osteolysis. This is often characterised by a gradual increase in pain which is aggravated by heavy gym work, and is usually in people under the age of 40. This is common in bodybuilders or athletes that place a large amount of stress on their shoulders. It can also occur in people who have very heavy, repetitive jobs. It is essentially a stress fracture of the outer end of your collar bone, and therefore requires a period of relative rest. Physio can help with your pain and range of movement, and then to help strengthen the muscles around the shoulder that are often neglected during weight training. Anti-inflammatory medication or steroid injections can also help with pain, but should not be used as an excuse to continue training in the same manner. If these measures don’t settle the pain then your physio may refer you to see a shoulder surgeon.
If you have any further questions or would like to book an appointment, please get in touch.