How to rehab shoulder ac joint

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How to rehab shoulder ac joint

Treatment for AC joint separation depends on the severity of the injury. Once a diagnosis is made, your therapist will work with you to develop an individualized treatment plan. Grade 1 AC Joint Separation: Physical Therapy Protocol If you sustain a grade 1 AC joint injury you may be required to: Wear a sling for 5-7 days Ice the injury for 48 to 72 hours Take anti-inflammatory medication As soon as symptoms begin to resolve, your physical therapist will structure a program that will focus on: Range of motion Strengthening exercises Manual therapy Functional training Patient education Most patients can expect to return to normal activities within two weeks. Grade 2 AC Joint Separation: Physical Therapy Protocol Immediate treatment for grade 2 AC joint separation may include: Wearing a sling for 1 to 2 weeks Icing the injury for 48 to 72 hours Taking anti-inflammatory medication Once cleared for therapy, your physical therapist will structure your recovery plan based on the above treatments, but with a more extensive approach. Patients can expect to return to regular activities within two to three weeks. Grade 3 AC Joint Separation: Physical Therapy Protocol Immediate intervention for grade 3 AC joint injury involves the same treatments as grade 1 and 2 joint separation. It was previously recommended that grade 3 ac joint injuries should be treated surgically, however, the growing consensus among medical professionals is that physical therapy is just as effective. Your physical therapist will encourage gentle range of motion and isometric exercises, followed by a more structured physical therapy program. Grade 3 AC joint separation physical therapy may last up to 8 weeks, or beyond, depending on the patient. Grade 4, 5, and 6 AC joint injuries usually require surgical intervention. 1. Tischer T., Salzmann G., El-Azab H., Vogt S., Imhoff A. Incidence of associated injuries with acute acromioclavicular joint dislocations types III through V. Am J Sports Med. 2009;37:136?141. [PubMed] [Google Scholar]2. Hincapie C., Morton E., Cassidy J.D. Musculoskeletal injuries and pain in dancers: a systematic review. Arch Phys Med Rehab. 2008;89:1819?1829. [PubMed] [Google Scholar]3. Ceccarelli E., Bondi R., Alviti F., Garofalo R. Treatment of acute grade III acromioclavicular dislocation: a lack of evidence. J Orthop Traumatol. 2008;9:105?108. [PMC free article] [PubMed] [Google Scholar]4. Post M. Current concepts in the diagnosis and treatment of acromioclavicular dislocations. Clin Orthop Relat Res. 1985;200:234?248. [PubMed] [Google Scholar]5. Walsh W., Peterson D., Shelton G., Neumann R. 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RepetitionsAROM Scapular retractions2 ? 252 ? 252 ? 25 Scapular clock1 ? 202 ? 15AAROM (towel) Shoulder lateral raise1 ? 152 ? 15 Shoulder front raise1 ? 152 ? 15 Shoulder adduction1 ? 152 ? 15 Wall climbs1 ? 152 ? 15 Codman pendulum1 ? 152 ? 15Shoulder isometrics External rotation 0? ABD2 ? 10 ? 7 s Internal rotation 0? ABD2 ? 10 ? 7 s Flexion2 ? 10 ? 7 s Extension2 ? 10 ? 7 s Abduction (ABD)2 ? 10 ? 7 s Adduction (ADD)2 ? 10 ? 7 s Scapular protractions2 ? 10 ? 7 s Scapular retractions2 ? 10 ? 7 s Shoulder depression2 ? 10 ? 7 sAROM ER at 0? ABDRed 1 ? 8Blue 3 ? 10 ER at 90? ABDRed 1 ? 8Blue 3 ? 10 IR at 0? ABDRed 1 ? 8Blue 3 ? 10 IR at 90? ABDRed 1 ? 8Blue 3 ? 10 Shoulder lateral raiseRed 1 ? 8Blue 3 ? 10 Shoulder front raiseRed 1 ? 8Blue 3 ? 10 Shoulder posterior raiseRed 1 ? 8Blue 3 ? 10AROM movement patterns Behind back1 ? 20 Behind head1 ? 20 Wall angel1 ? 20 D1 movement pattern1 ? 20 D2 movement pattern1 ? 20Proprioception Body blade circles1 ? 10 ? 10 s2 ? 10 ? 10 s Body blade alphabet1 ? 26 letters2 ? 26 letters Push-ups on BOSU1 ? 83 ? 10General conditioning Push-up plus4 ? 10 Lat pull-down 100 lb4 ? 10 Seated rows 100 lb4 ? 10 Shoulder ant. raises 5 lb4 ? 10 Shoulder lateral raises 5 lb4 ? 10 Prone shoulder raise 5 lb4 ? 10 Elbow flexion 25 lb4 ? 10 Elbow extensions 50 lb4 ? 10Plyometricsa Push-up with clap4 ? 6 Medicine ball toss 8 lb4 ? 6 Medicine ball throws 8 lb4 ? 6 You should ask your doctor whether these exercises are safe for you to do and perform them under clinical supervision to ensure proper form. Image Credit: Sophie Walster/iStock/GettyImages An acromioclavicular (AC) joint injury -- also known as a shoulder separation -- can make it difficult for you to go about your daily life, especially if it involves your dominant arm. Here's what you need to know about AC joint rehab, and some exercises you can do to help your shoulder heal. Certain exercises can help stretch and strengthen your shoulder. Do not perform any exercises without consulting your doctor first. Causes of AC Joint Injuries The Mayo Clinic Sports Medicine explains that the AC joint is where the collarbone (clavicle) meets part of the shoulder blade (acromion). This joint plays an important role in maintaining the position of the shoulder. It also helps with shoulder control, strength and motion. Ligaments and a capsule help stabilize this joint. Damage to any of these structures results in an AC joint injury. According to the American Academy of Orthopaedic Surgeons (AAOS), the most common cause of an AC joint injury is a fall directly onto the shoulder. Saint Luke's Health System says falling on your outstretched hand or receiving a direct blow to the shoulder can also cause this injury. The Mayo Clinic Sports Medicine notes that the AC joint is also susceptible to arthritis, which can be extremely painful. This is especially common among laborers and weight lifters, due to years of degeneration, or wear and tear, of the joint. A July 2018 study published in the journal EFORT Open Reviews states that athletes and people who play contact sports are also at a higher risk of injuring their AC joints. AC Joint Rehabilitation Depending on the amount of force to the shoulder when the injury occurred, the ligaments attached to the underside of the collarbone could also tear, causing it to separate from the shoulder blade. Per the AAOS, this causes the shoulder blade to droop downward with the weight of the arm, and creates a big bump above the shoulder. An AC joint injury can range from a mild sprain with no bump in sight to a complete disruption of the joint with a very large bump. A December 2018 study published in the World Journal of Orthopedics reviews the current practices in AC joint rehabilitation. The authors of the study note that AC joint injuries are typically graded in severity on a scale of I to VI. While Types I and II typically don't require surgery, Types IV, V and VI usually do. Type III injuries are controversial, because some doctors prefer to operate whereas others don't. Saint Luke's Health System explains that non-surgical AC joint rehabilitation can involve rest, ice packs, pain medication, a sling and certain arm and shoulder exercises. AC Joint Injury Exercises Kaiser Permanente lists some exercises that can help rehabilitate your shoulder. You should ask your doctor whether these exercises are safe for you to do and perform them under clinical supervision to ensure proper form. Your doctor will also tell you when you should start doing the exercises and how often you should do them. These exercises are intended to stretch and strengthen your shoulder. According to the AAOS, stretching your shoulder can help dispel muscle soreness, restore your range of motion and prevent further injury. Strengthening the muscles that support your shoulder helps stabilize the joint and relieves pain. You shouldn't feel any pain beyond mild discomfort while you do the exercises. You will need a stick for some of the exercises listed here. Kaiser Permanente says you can use a broom handle (with the bristles removed) or a piece of PVC pipe. The stick should be about 1 foot longer than the width of your shoulders. Move 1: Neck Rotation Sit in a chair or stand upright with your back, shoulders and head straight. Keeping your chin level, slowly turn your head to one side. Hold this position for 15 to 30 seconds. Bring your head back to the center. Repeat this exercise two to four times on each side. Sit in a firm chair or stand upright with your feet planted shoulder-width apart. Roll your shoulders first upward, then downward, in a smooth, circular motion. Repeat this exercise two to four times. While looking straight ahead, drop your head to the right side, toward your right shoulder. Keep your left shoulder in place as you drop to the right side; don't let it rise upward toward your left ear. Hold this position for 15 to 30 seconds. Bring your head back to the center. Repeat this exercise two to four times on each side. Move 4: Shoulder Blade Squeeze Stand upright with your arms by your sides. Without raising your shoulders, squeeze your shoulder blades together, bringing them as close to each other as you can. Hold there for six seconds, then release. Repeat this exercise eight to 12 times. You will need a stick for this exercise. Lie down on your back, bend your knees and plant your feet on the floor. Hold the ends of the stick in your hands, keeping your elbows straight and your palms facing the floor. Slowly raise your arms over your head, until you feel a stretch in your chest, back and shoulders. Don't let your arms bend at any point during this movement. Hold this position for 15 to 30 seconds. Bring your arms back to their original position. Repeat this exercise two to four times. Move 6: Standing Shoulder Extension You will need a stick for this exercise. Stand upright and hold the stick in both hands behind your back. Your hands should be placed shoulder-width apart on the stick, with your palms facing away from your body. Move the stick backward, away from your body. Take it as far back as you can without feeling pain. Hold this position for six seconds. Bring your arms back to their original position. Repeat this exercise eight to 12 times. Move 7: Goal Post Stretch You will need a stick for this exercise. Lie down on your back, bend your knees and plant your feet on the floor. Hold the ends of the stick in your hands, with your palms facing your knees. Rest your elbows on the floor, perpendicular to your body. The stick should be above your chest. Move the stick backward over your head. Go as far back as you can without feeling pain. Try to reach far back enough that you can rest the stick on the floor behind your head. Hold this position for 15 to 30 seconds. Bring your arms back to their original position. Repeat this exercise two to four times.

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