This often happens after a fall onto the shoulder, a heavy tackle, or an awkward landing during sport. You may notice swelling, bruising, or pain when lifting your arm overhead or across your body. These are common signs of an acromioclavicular (AC) joint injury, often referred to as ACJ Shoulder pain, something we frequently treat at Physio on the Green. ACJ Shoulder pain can affect people of all ages and activity levels.
Here’s what to expect from assessment through to a safe return to activity if you are experiencing ACJ Shoulder pain.
What is an AC Joint Injury?
The AC joint is where the collarbone meets the shoulder blade. It plays an important role in overhead and cross-body movements. Shoulder pain at the ACJ is something that can considerably limit these motions.
An AC joint injury occurs when the ligaments stabilising this joint are sprained or torn, most commonly due to a direct impact or fall onto the shoulder. Importantly, ACJ pain in the shoulder is most often related to ligament damage here.
How Do AC Joint Injuries Occur?
Common mechanisms include various incidents that often result in ACJ Shoulder pain:
- Falls directly onto the shoulder
- Contact sports (rugby, football, hockey)
- Cycling or mountain biking accidents
- Heavy lifting or sudden traction forces
Types of AC Joint Injuries
Low-Grade Sprains (Grade I–II)
- Localised pain on top of the shoulder, which may be described as ACJ pain.
- Mild swelling or tenderness
- Pain with overhead or cross-body movements, sometimes referred to specifically as ACJ Shoulder pain.
- Usually recover well with structured rehab
Higher-Grade Injuries (Grade III+)
- More significant ligament injury may lead to ongoing ACJ pain in the shoulder.
- Visible “bump” or deformity
- Greater pain and loss of function, with ACJ Shoulder pain being a characteristic sign.
- May require longer rehabilitation or specialist review
How Can We Help at Physio on the Green?
Assessment & Diagnosis
We perform a thorough assessment to determine injury severity and contributing factors, including ACJ Shoulder pain patterns:
- Shoulder and AC joint-specific testing for ACJ pain
- Range of motion and strength assessment
- Scapular and movement control analysis
Imaging (X-ray, ultrasound, or MRI) is arranged if required, especially when ACJ Shoulder pain is persistent.
Rehabilitation: Restoring Strength & Confidence
Early Phase
- Pain and swelling management is crucial for ACJ Shoulder pain in the early phase.
- Activity modification
- Gentle shoulder mobility helps reduce ACJ pain.
- Early rotator cuff and scapular activation
Mid Phase
- Progressive strengthening of:
- Rotator cuff – vital for reducing ACJ Shoulder pain.
- Scapular stabilisers
- Shoulder girdle
- Rotator cuff – vital for reducing ACJ Shoulder pain.
- Gradual return to overhead and cross-body movements, which is often limited by ACJ pain.
Late Phase
- Higher-load strengthening sessions may help address recurring ACJ Shoulder pain.
- Dynamic and sport-specific drills
- Objective testing to guide return to activity – Handheld dynomometry, especially important if ACJ pain persists.
Return to Sport or Daily Activity
Before returning, we assess whether ACJ Shoulder pain remains a limiting factor:
- Strength and endurance
- Movement quality and shoulder control
- Confidence under load, particularly if ACJ pain has been an issue.
Return is guided by objective criteria, not just time. Moreover, managing ACJ Shoulder pain is essential for regaining full function.
Final Key Takeaway
An AC joint injury is more than just a sore shoulder. With the right assessment and rehabilitation, most people make a full recovery, even after experiencing ACJ Shoulder pain. At Physio on the Green, we focus on restoring strength, stability, and confidence so you can return to what you love without hesitation.
Book an appointment or get in touch, your shoulder deserves the right rehab!