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Ac Joint Physical Therapy Exercises

How Long Does It Take For An Ac Joint Sprain To Heal

AC Joint Pain Exercises for Shoulder Rehab

Ligamentous healing can vary from 4 weeks for mild sprains all the way up to several months for more severe grade 3 sprains. AC Joint sprains, in particular, can be quite frustrating because they can significantly limit someones daily activities that involve reaching, carrying, and lifting objects.

It is important to remember that ligament sprains are notoriously slow healers and that is imperative to protect the AC Joint ligaments with a shoulder sling and/or taping technique to promote an optimal outcome in the end.

Can This Injury Or Condition Be Prevented

Accidents happen and it can be difficult to prevent many traumatic AC joint injuries. However, much can be done to prevent the string of events that lead to overuse injuries. Physical therapists can help reduce overuse injuries by:

  • Teaching you how to properly lift objects overhead at work.
  • Demonstrating good form for overhead resistance training or sports activities.
  • Helping you maintain general shoulder strength and motion to safely perform tasks.

Consult a physical therapist as soon as possible if you have persistent constant or worsening symptoms.

Physical Therapist’s Guide To Acromioclavicular Joint Injuries

Physical Therapist’s Guide to Acromioclavicular Joint Injuries

Acromioclavicular joint injury is a term used to describe an injury to the top of the shoulder, where the front of the shoulder blade attaches to the collarbone . It can be caused by a traumatic event, such as a fall directly on the outside of the shoulder, or by repetitive overuse. AC joint injuries are most common in individuals younger than 35 years of age, with males sustaining 5 times more traumatic AC joint injuries than females. Because younger athletes are most likely to participate in high-risk and collision activities, such as football, biking, snow sports, hockey, and rugby traumatic AC joint injuries occur most often in this population. AC joint injuries can be identified and effectively treated by a physical therapist, often avoiding the need for surgery.

What Are Acromicioclavicular Joint Injuries?

There are 4 ligaments holding the 2 bones of the AC joint together. When an AC joint injury occurs, these ligaments are stressed, resulting in some degree of joint separation. There are 2 types of injuries that can occur at the AC joint: traumaticand overuseinjuries.

A traumatic AC joint injuryoccurs when there is a disruption of the joint due to damaged ligaments holding the 2 bones of the joint together. This injury is called a shoulder separation.

How Does it Feel?

With an AC joint injury, you may experience:

How Is It Diagnosed?

How Can a Physical Therapist Help?

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Wide Grip Bench Press

A wide grip bench press is one of the AC joint exercises to avoid. It tends to be one of the main problems of people with AC joint injuries.

Pain is induced while performing this exercise for the same reasons as those mentioned above. Mechanically, it places an unfavourable amount of tension and impact on the wounded AC joint.

What Are The Best Exercises For Ac Joints

Ac Joint Sprain Exercises

If you have a damaged or injured acromioclavicular joint, then ac joint exercise should begin with movements that stabilize the scapula.

Then follow up with shoulder-strengthening exercises for the entire shoulder girdle complex.

The ac joint, at the top of the shoulder, connects the scapula to the clavicle and can be exacerbated by repeated overhead tasks.

If you have a natural and pain-free range of motion in your shoulder, then you can start AC Joint Stabilization exercises starting with those that help to reinforce and stabilize the scapula.

They include

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What Are Acromicioclavicular Joint Injuries

There are 4 ligaments holding the 2 bones of the AC joint together. When an AC joint injury occurs, these ligaments are stressed, resulting in some degree of joint separation. There are 2 types of injuries that can occur at the AC joint: traumatic and overuse injuries.

A traumatic AC joint injury occurs when there is a disruption of the joint due to damaged ligaments holding the 2 bones of the joint together. This injury is called a shoulder separation .

Traumatic AC joint injuries are most common in individuals who sustain a fall and land on the outside of the shoulder or onto a hand (eg, a football player who is tackled, a bicyclist who crashes, or a manual laborer who falls off a ladder.

Traumatic AC joint injuries are graded from mild to severe based on the amount of separation of the joint. Treatment of mild cases likely will be provided by a physical therapist more severe cases may require surgery followed by physical therapy.

Duration Of Ac Joint Physical Therapy

The length of your physical therapy depends on the severity of your AC joint injury. For Type I and II injuries, it may take two to three weeks to adequately heal. If surgery is necessary to correct your AC joint separation, then physical therapy could last anywhere between in eight and 12 weeks.

After your physical therapy is complete, its important to follow your physical therapists orders. You may also want to continue your stretches and exercises. Just be mindful not to increase your lifting and pulling weight too quickly, as reinjury is a high possibility.

If youre experiencing shoulder pain due to an AC joint injury, request an appointment online to meet with one of our shoulder specialists or call 825-0540. Following diagnosis and treatment of your condition, our physicians may refer you to our skilled physical and occupational therapists.

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Upper Back Lift With Elbows

It strengthens the upper back and muscles that help enhance the posture. Lie with your face down on a mat and your hands on your shoulders and legs long and stretched out.

Lift your upper body, keeping your legs rooted to the mat, raise your elbows higher, keeping your fingertips on your shoulders, or just with your hands on your side.

Have your nose pointing to the floor to keep your neck balanced properly. Repeat up to 5 times to keep your body aligned and abs and upper back working longer as you advance.

Phase 4 Return To Activity Phase

AC Separation Physical Therapy, Exercises and Recovery

Phase 4 lasts from week 16-24, and your goals are to maintain your passive and active range of motion stretches and exercises while you return to strenuous activity and full recreational activities.

Even though youre at the end of your rehabilitation, you still need to take care to protect your shoulder. For example, you can avoid excessive anterior capsule stress by avoiding movements like tricep dips, wide grip bench presses, and behind-the-head lat pulls. You should also avoid any throwing or overhead athletic movements until your surgeon clears you.

During phase 4, you continue with all the exercises and movements youve added during the previous 16 weeks. You will also add:

  • Isometric strengthening movements
  • Overhead range of motion movements
  • Progressive weight lifting with your arms, shoulders, chest, and back
  • Polymetric and interval training

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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

Most patients can expect to return to normal activities within two weeks.

Symptoms Of An Ac Joint Sprain

Initial symptoms of an AC Joint sprain will include:

  • Shoulder pain originating from the AC Joint located at the top of the shoulder
  • Tenderness to palpation at the joint will be present
  • A step-sign will be present with a Grade 2 AC Joint sprain or higher
  • There will be a noticeable shift or separation in the bones on either side of the joint. This can be felt with your fingers on the joint and seen with the naked eye. X-rays can also easily confirm the presence of a step-sign as seen in the image below.
  • Pain originating from the top of the shoulder with active arm elevation
  • Weakness with arm elevation
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    The 5 Best Ac Joint Treatment Exercises

    Seated Wand Flexion

    • Use a lightweight wand, stick or broom
    • Use the non-painful arm to lift the painful arm up in front of you and overhead. Stop at the onset of pain or stretch
    • Keep the painful arm relaxed throughout the motion
    • Perform: 2 sets x 10 reps

    Seated Wand Abduction

    • Use a lightweight wand, stick or broom
    • Use the non-painful arm to lift the painful arm out to the side and overhead. Stop at the onset of pain or stretch
    • Keep the painful arm relaxed throughout the motion
    • Perform: 2 sets x 10 reps

    Wall Walks Exercise

    • Use the pads of your fingers to actively climb up the face of a wall with your hand.
    • Be sure to use the pads of the fingers to pull the weight of the arm up rather than just sliding the hand up. This allows the shoulder muscles to stay relaxed while letting the hand do most of the work
    • Pause at the top, then use friction with your hand to slide at a controlled rate back to the starting position
    • Perform: 10-15 reps

    Shoulder Shrugs Exercise

    • Make sure to use weights that DO NOT cause increased shoulder pain simply when holding the weight at your side! If they cause pain at the AC Joint, use a lighter pair of dumbbells.
    • Shrug your shoulders as if you were trying to touch your shoulders to your ears
    • Perform: 3 sets x 10 reps

    Overhead Shoulder Shrugs Exercise

    Physical Therapy In Corpus Christi For Shoulder

    shoulder exercises for ac joint

    Welcome to Humpal Physical Therapy & Sports Medicine Centers patient resource about Osteoarthritis of the Acromioclavicular Joint.

    Some joints in the body are more likely to develop problems from normal wear and tear. Degeneration causes the cartilage that cushions the joint to wear out. This type of arthritis is called osteoarthritis. Doctors sometimes refer to this type of arthritis as arthrosis.

    The acromioclavicular joint in the shoulder is a common spot for osteoarthritis to develop in middle age. Degeneration of the AC joint can be painful and can cause difficulty using the shoulder for everyday activities.

    This guide will help you understand:

    • what the AC joint is and how it works
    • the causes of pain and problems in the AC joint
    • the treatments used for this condition

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    Exercises To Avoid Following Acromioclavicular Joint Injury

    Several weeks ago, a mid-60s male came to the clinic presenting with an AC Joint separation after falling from his mountain bike This patient is very active he regularly participates in a mens competitive soccer league and mountain biking. After suffering the injury and experiencing signs and symptoms of pain, decreased range of motion , and weakness of the shoulder, the patient assumed surgery was his only option.

    Prior to beginning therapy, the patient had consults with three different orthopedic surgeons, all of whom recommended physical therapy as an initial treatment. Upon meeting him, hearing how he injured his shoulder and the activities he wants to return to, I knew his personality type as one to push through the pain when exercising.

    I asked the patient what, if anything, he has been doing at home after the injuryeither to decrease pain or improve function. He mentioned that he would attempt to apply an aggressive cranially directed force to the shoulder in an attempt to correct his step deformity that was present after injury. He made a point to mention how much he visually disliked the look of the step deformity that was present after injury! When I looked at his shoulder and the amount of vertical displacement present, I presumed hat he had a grade 3 separation at minimum.

    Did that help? I asked.

    EhhIm not too sure, but it does push it back up and makes it look nicer

    Phase 2 Intermediate Phase

    Phase two usually lasts from week 4-9. During this time, you focus on minimizing your shoulder pain and swelling while gradually restoring your active range of motion and reducing the time you spend wearing your sling. You should continue to take precautions to protect your shoulder. You should:

    • Avoid active movements until your physical therapist gives you the all-clear
    • Dont lift anything with your treated shoulder
    • Dont perform any exercises that put force on your anterior capsule of your shoulder like push-ups and pectoral flyes
    • Dont perform scaption

    You and your physical therapist continue to work on passive range of motion movements including:

    • Forward flexion and elevation
    • Abduction in the scapula plane
    • Internal rotation to 45 degrees at 30 degrees of abduction
    • External rotation building to 45 degrees at a 30-40 degree abduction
    • Glenohumeral joint mobilizations
    • Minimize mobility restrictions in your trunk and in the joint where your shoulder blade meets your ribs
    • Introduce posterior capsular stretching including crossbody adduction and side-lying internal rotation stretches

    External Rotation

    Isometric Internal Rotation

    Isometric External Rotation

    • Internal and external rotations with resistance tubing
    • Side-lying external rotations with a towel roll
    • External rotations with manual resistance while you lie down with your arm extended to the side
    • Prone rowing at different angles of abduction ranging from neutral to 90 degrees

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    Overuse Ac Joint Injury

    When excessive demand is placed on the AC joint for an extended period of time, the cartilage that protects the bones can become stressed. Cartilage that sustains significant stress and wear is known as arthritis.

    This can occur in individuals who engage in repetitive activities that involve stretching the arms over the head.

    For example:

    If you sustain an AC joint injury, you may experience:

    • Pain and swelling
    • Tenderness over the AC joint
    • Loss of strength and motion in the shoulder
    • Popping sound or a catching feeling when moving the shoulder
    • A noticeable bump on top of the shoulder
    • Discomfort in the shoulder when lifting, reaching or carrying objects

    A physical therapist can identify and treat AC joint injuries. You may be required to have diagnostic imaging tests to determine the extent of the injury, such as:

    Your physical therapist will conduct a couple of different tests and will ask you to demonstrate the movement and activities that cause discomfort.

    The examination will include surrounding areas of the body, such as the neck and back, to determine how they may be contributing to the injury.

    Ac Joint Sprain Exercises & Rehabilitation

    AC Joint Sprain Stretches & Exercises – Ask Doctor Jo

    Rehabilitation exercises for an AC joint sprain or separation will depend on the severity of the injury. Exercises should begin only when the ligaments have healed, and you have no pain during normal daily activities.

    The following guidelines are for information purposes. We recommend seeking professional advice.

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    Phase 3 Strengthening Phase

    Phase 3 typically lasts from weeks 12-15, and you focus on rebuilding your strength, endurance, and neuromuscular control. Your goals are to return to full chest level functional activities and gradually increase the stress your shoulder can sustain.

    While building your shoulder strength, you need to take care not to over-stress your shoulder and avoid all contact sports and activities. You should also only progress as directed by your physical therapist.

    Phase 3 activities include:

    • Continuing with active and passive range of motion movements
    • Bicep curls with light resistance
    • Exercises for your chest muscles avoid overstressing your shoulder joint
    • Progressive push-up movements using the wall, counter, and knees to build strength before performing toe push-ups
    • Crossbody diagonal movements with resistance tubing
    • Internal rotations with resistance bands at varying degrees of abduction
    • Forward punches

    Side Lying Internal Rotation Stretch

    Shoulder Joint Mobilization

    Ac Joint Physical Therapy Will Pt Help

    If youve suffered from a traumatic or overuse injury of your AC joint, not only cana physical therapist diagnose the issue, but they will most likely be able to treat the separation without the need for surgery.

    Depending on the extent of your injury, your physical therapist can help you return to your normal activities within as little as two weeks.

    Immediate diagnosis and treatment are recommended for the best results.

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    Physical Therapy Goals For Ac Joint Injuries

    • Physical Therapy Goals for AC Joint Injuries

    Located at the highest point of the shoulder, the acromioclavicular joint connects the clavicle and the acromion, which is part of the scapula or shoulder blade. A painful AC joint dislocation can result from a sports accident, fall, or other trauma leaving your shoulder dislocated.

    The severity of an AC joint separation is commonly classified as one of three types:

    Initial Treatment After An Ac Joint Sprain/separation

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    If youve been unfortunate enough to have just suffered an AC Joint sprain, follow these steps:

  • Wear a shoulder sling for 2-4 weeks
  • Shoulder slings are important to wear throughout the day initially after a sprain to allow for the injured ligaments to begin to heal in an approximated position. If you dont wear a sling, the ligaments will heal in a stretched position as the arm weight is constantly pulling down on AC Joint ligaments.
  • Tape the AC Joint for extra support
  • Use Leukotape and Cover Roll in a cross technique to help stabilize the AC Joint when performing physical therapy exercises out of the sling for the first 2-4 weeks, then continue using the tape as needed when exercising for up to 3 months after the injury.
  • Watch how to tape the AC Joint in my instructional videoat the bottom of this article.
  • Use Cryotherapy as needed for pain relief
  • Use a quality gel cold pack for 10-15 minutes on the shoulder as needed
  • DO NOT lift or carry heavy objects with the injured arm for at least 8 weeks while the ligaments are healing
  • Let pain be your guide. If it hurts the AC Joint when doing something with the arm, try to not do that activity or at least modify the activity to reduce the stress on the joint as much as possible
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