Rehabilitation of AC Joint Injuries

Rehabilitation of AC joint Injuries

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Rehabilitation of AC Joint Injuries

The following guidelines are for information purposes only. We recommend seeking professional advise before

attempting any rehabilitation programme.

It is important that full mobility is maintained or regained in the shoulder joint for rehabilitation to be successful. In

addition the athlete must also have correct biomechanical function of the shoulder joint. This is easily lost if the

athlete has suffered an injury of the shoulder for any length of time. In particular the shoulder blade (scapular) and

upper arm bone (humerus) should move together. In the injured athlete this 'rhythm' is often lost.

Following a period of icing and immobilisation for grade 1 & 2 injuries, mobility exercises as below can be

undertaken, but only once shoulder movement is pain free (normally 7-14 days for grades 1 and 2). Grade 3 injuries

are now more frequently being treated with conservative treatment, rather than surgery. However, due to the extent

of damage it is highly recommended to see a Sports Injury Specialist or Doctor.

Pendulum exercises:

Gradually increase the range

of motion

Mobility

Pendulum exercises

Gently swing the arm forwards, backwards and sideways whilst lying on your front or bent over as seen opposite.

Gradually increase the range of motion. This is repeated with the arm swinging from side to side as well. Aim to

reach 90 degrees of motion in any direction.

Front of shoulder against a wall or doorframe

Place one forearm on a fixed point such as a doorframe or corner of a wall and gently turn away from it to stretch

the front of the shoulder.

Hold the position for 10 to 20 seconds and repeat 3 times. The athlete should feel a gentle stretch in the front of

the shoulder but not pain.

Stretching the front of the

shoulder

External rotation stretch

Lying on back with the arm bent and raised out to the side (abducted) at 90 degrees.

Rotate the shoulder back so the palm of the hand faces upwards.

Hold the position for between 2 and 3 minutes.

Stretches can be done on a daily basis assuming there is no pain. Stretching must be done regularly and continued

throughout the rehabilitation process.

Strengthening



External rotation stretch

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Strengthening of the muscles surrounding and supporting the shoulder can begin in line with the mobility exercises

as shown above, as long as the shoulder remains pain free. Strengthening should initially be isometric, meaning

contracting the muscles without movement.

Stand side on to a wall, with your upper arm by your side and the elbow bent.

Place the back of the wrist against the wall and try to push the wall away.

Start off applying a gentle pressure and gradually increase how hard you push.

Hold for 10 seconds, rest for 3-5 and repeat up to 10 times.

This same principle can be applied for several different exercises:

With the arm in the same position, rotate your body to face the wall, place the front of the wrist against the wall

(around the corner) and try to rotate your arm towards you.

Again, standing side-ways on to the wall, straighten the elbow; place the back of the wrist and hand against the

wall and try to push the wall away.

Isometric rotator cuff

strengthening

After a week of pain free mobility and isometric strengthening exercises, strengthening can be progressed.

Stretching should continue throughout this phase. An excellent piece of equipment to use to strengthen the shoulder

is a resistance band, as shown in picture 2. Exercises can be progressed to isotonic, using resistance in a number of

ways, with one piece of equipment.

External Rotation

Attach the band to something stable as shown, holding one end, with the upper arm fixed against the body and

the elbow bent.

Pull the band so that the hand and forearm move away from the body whilst keeping the elbow against your side.

Perform 3 sets of 10 repetitions with a minute rest between sets.

Strengthening the rotator

cuff using a resistance band

When using resistance bands start using a long length, if it is too easy you can shorten the band to provide more

resistance.

Internal Rotation

This is the exact opposite movement to external rotation.

With the same starting position, pull your hand in, towards your stomach, again keeping the elbow by your side.

Note you will have to turn yourself around to apply resistance to the exercise so that you are pulling the band

from your side, across your body.

Lateral Raise

Alternative rotation exercise

using a dumbbell

Still using the resistance band, stand on one end of the band, with the other end in your hand.



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Keeping the elbow straight, pull your hand up to level with your shoulder ensuring you maintain a good posture

throughout.

Again perform 3 sets of 10 repetitions. This can be performed just as easily with a small dumbbell.

Alternative to Internal and External Rotation

Using a small weight, place the elbow on a bench or similar with the upper arm horizontal. Rotate the shoulder to

lift the weight through as large a range of motion as is comfortable.

Return to Sport

Before returning to any type of sport following an AC joint injury there should be a full pain-free range of motion

On return to contact sports, protection can be provided by padding the joint with a circular piece of padding with

a hole cut in the middle which should be centered over the joint. This can be kept in place with bandaging or a

shoulder support

Stretching, mobility and strength exercises should be continued throughout the return to sport phase



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