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The
Injury
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- The acromio-clavicular joint (AC
joint) is part of the shoulder complex.
- It is situated at the outside point
of the collar bone where it attaches to the front of the shoulder
blade.
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There are 3 basic types
of injury:
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The AC joint ligaments are most commonly
damaged through a fall onto the tip of the shoulder, although in
collision sports this force may come from an opponent. The impact forces
the shoulder blade down and stretches the ligaments away from the collar
bone.
- If the force is not great, a Type 1
injury will occur, in which there is only a mild sprain of the
ligaments.
- With more force, a Type 2 injury
occurs. This is a more severe sprain and the AC joint is slightly
separated but still intact.
- The most severe injury is the Type 3
injury, in which the ligaments of the AC joint are ruptured and
there is a dislocation. In this situation the collar bone becomes
loose and can come to rest in several unorthodox positions.
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Signs
and Symptoms
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- Most obviously, there is pain and
tenderness on the outer part of the collar bone.
- This is made worse by shoulder
movements.
- The injured person will
instinctively cradle the affected shoulder and try to keep it
immobile.
- If there is a Type 3 injury, the
outer part of the collar bone may be sticking upwards and producing
a visible lump.
- An x-ray should be taken to confirm
the diagnosis. This will reveal the degree of separation within the
AC joint.
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Treatment
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- In the acute stage of the injury
pain-relieving medication is helpful. Ice packs should be applied to
the injured shoulder for 20 minutes every two hours
(never apply ice directly to the skin)
. A physical therapist or trainer can apply a taping technique, which
will push the collar bone downwards, and the shoulder should then be
placed in a sling and rested. While the shoulder is in a sling it is
important to keep the fingers, wrist and elbow mobile by going through
their full range of movement every four hours or so.
- In the case of Type 1 injuries, the
symptoms usually subside in 7 to 10 days and the sling should then be
discarded. Gentle pendulum exercises for the shoulder should be
initiated and the range of movement in the shoulder should be
gradually increased within the limits of pain. Heavy lifting should be
avoided until there is full painless range of movement in the shoulder
and the tenderness has subsided
- The treatment for a Type 2 injury is
similar, but the sling will have to be worn for about 2 weeks. After a
week gentle range of movement exercises should be started. Twice a day
the sling should be removed to perform these movements within the
limits of pain. The shoulder should be used as normally as possible
for washing and dressing activities, but contact sports and heavy
lifting should be avoided for at least 6 weeks.
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Prevention
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- Attention
must be paid to flexibility, strength and endurance of the shoulder
muscles
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