The acromioclavicular (AC) joint is the articulation between the acromion of the scapula and the collarbone (clavicle). Together with the glenohumeral, sternoclavicular and scapulothoracic joints, the AC joint is enables shoulder movement.
The acromioclavicular ligaments support the AC joint.
What causes acromioclavicular joint pain?
In AC joint problems, the acromion has moved relative to the clavicle. This misalignment stretches the acromioclavicular ligaments, thus causing pain.
Acromioclavicular joint dysfunction has two mechanisms of injury:
- direct force to the superior aspect of the acromion which drives the acromion inferiorly. This can be seen after a fall onto the shoulder or a knock on the shoulder.
- FOOSH (fall on an outstretched hand) which transmits force up the arm, through the humeral head and into the acromion. FOOSH injuries are commonly seen in rugby, and bicycle accidents.
In practice, I often find AC joint dysfunctions that are not painful. Once found – I use AK muscle testing for accurate diagnosis – the AC joint is easy to treat with osteopathy.
What are the symptoms of AC joint injuries
As is typical for ligament injuries, AC joint sprains are graded in types 1, 2, and 3. In brief, the higher the grade, the more severe the injury and the more pronounced the symptoms.
However, AC joint dysfunctions can also be asymptomatic. In such cases, an underlying AC joint dysfunction may be involved in other shoulder conditions. I frequently find that after I have treated asymptomatic AC joint dysfunctions, other shoulder conditions improve considerably.
Type 1 AC ligament sprain
- local to AC capsule
- +/- trapezius, levator scapula muscle spasm
- no visible displacement, so not visible on x-ray
Type 2 AC ligament sprain
- AC capsule and coracoclavicular ligament involvement
- tenderness over the AC joint and coracoid process
- marked trapezius, levator scapula muscle spasm
- visible elevation of the clavicle, evident on x-ray
Type 3 AC ligament sprain
- major AC capsule and coracoclavicular ligament involvement
- severe AC and coracoid tenderness
- visible displacement
What treatments are there for AC joint sprains?
Immediately after an injury, you should protect, rest, and ice the AC joint. If the shoulder is very acute, you may be advised to use an arm sling to immobilise the shoulder. We are generally very intuitive and will naturally want to keep the arm in the best position. Pain will inform us what the best position for the shoulder is.
Once the initial swelling and pain have reduced, AC joint problems respond very well to conservative treatment.
You can see an osteopath, herbalist or an acupuncturist.
An acupuncturist will be able to reduce local inflammation and work with channels (meridians) that are associated with muscles that support the AC joint. Acupuncture also considers local shoulder points.
Herbalists can prescribe herbs that are anti-inflammatory and promote wound/connective tissue healing. Osteopathy has a more mechanical approach.
Osteopathy, acupuncture, and herbal medicine complement each other very well.
In rare cases, surgery may be performed. AC joint surgery should only be considered in the unlikely event that osteopathy, acupuncture, and herbal medicine have not helped.
Can osteopathy help AC joint sprain?
Luckily, osteopathy is extremely valuable for AC joint problems. An osteopath will be able to gently realign the joint, reducing the stretch on the ligaments.
An osteopath will also address associated muscle spasms. (Certain muscles will initially spasm as a protective mechanism. This is an attempt to immobilise the shoulder to prevent further injury.)
Osteopathic treatment of the neck will help the nerve supply of the shoulder muscles, e.g. the deltoid that stabilizes the AC joint.
So, if you have an AC joint sprain or think you may have an underlying AC joint problem, you are likely to benefit from seeing an osteopath.
To book an Osteopathy appointment in New Malden or in Marylebone, phone 020 8942 3148 or contact Aston Clinic London.
Aston Clinic London is a third-generation complementary health clinic based in New Malden and serves the local areas of Kingston, Wimbledon, Raynes Park, Surbiton, Chessington, Worcester Park, Sutton and other areas of southwest London and Surrey.
Aston Clinic London also offers Osteopathy and Herbal Medicine in Marylebone, Central London.
