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AC Joint Sprain

The AC joint is the acromioclavicular joint, which is formed by the distal (shoulder) end of the clavicle (collar bone) and the acromion process of the scapula (shoulder blade). An AC joint sprain is damage to the ligaments which connect these two bones.

This injury is graded on a scale from 1 to 6 known as the rockwood scale. Grade 1 is a minor sprain to the acromioclavicular (AC) ligament and damage increases to include damage to the coracoclavicular (CC) ligament and then displacement of the clavicle, as the scale progresses.

AC joint injuries usually occur in either contact settings where there is a direct impact to the point of the shoulder, or through falling onto either the point of the shoulder, or an outstretched hand.


Symptoms of an AC joint injury vary depending on the severity of the damage but generally include:

  • Pain on the top of the shoulder, at the end of the collar bone.
  • Pain on palpation of the AC joint.
  • Pain when lifting the arm away from the side.
  • Swelling around the joint.

In more severe cases (grade 3+) a step deformity may be present. This is a lump at the location of the joint, where it has been disrupted and the clavicle is raised up (usually). Grades 4, 5 and 6 are classed on the degree and direction of displacement of the clavicle.


Treatment of an AC joint sprain will vary depending on severity, however the immediate stages of treatment are the same:

  • Rest the shoulder immediately and immobilise if possible with a sling.
  • Apply ice to the area to help reduce pain and inflammation.
  • Consult a Doctor or sports injury specialist.
  • You may be prescribed anti-inflammatories such as Ibuprofen.

Grade 1 and 2 injuries will usually require immobilisation for a one to two week period, followed by a gradual return to movement and isometric (no movement) strengthening exercises.

Grade 3 injuries may be treated with the following methods:

  • Tape to the joint to keep the collar bone down and allow the ligaments to heal.
  • Ultrasound or TENS electrotherapy methods may be beneficial.
  • Immobilisation for up to 6 weeks.

Surgery is now usually reserved for types 4, 5 and 6. If a type 3 injury fails to heal with conservative methods as outlined above, surgery may also be considered.

Further Information

  • AC Joint Separation - for further information on treatment including rehabilitation, taping, sports massage, stretching and more visit sportsinjuryclinic.net
  • Visit Sportsinjuryclinic.net for more detailed information on shoulder injuries.




AC joint sprain grade 1 injury sprain of acromioclavicular ligament
Grade 1 AC joint injury - Sprain of the AC ligament only


AC joint injury grade 3 - ruptures of acromioclavicular and coracoclavicular ligaments
Grade 3 AC joint injury -Rupture of AC and CC ligaments with minor displacement of the clavicle

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