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Acromioclavicular Joint (AC joint) Injuries & How We Fix Them

Acromioclavicular Joint (AC joint) injuries are among the most common year-round shoulder injuries we see at Vail-Summit Orthopaedics & Neurosurgery. Let’s start by answering three questions: What exactly is the AC joint? What activities lead to injury of the AC joint? How do we treat AC joint injuries?

Your AC joint is the connection between your clavicle (or collarbone), and your scapula, (or your shoulder blade). This important stabilizer is the boney connection between your scapula and your chest wall. As you follow your clavicle from the top of your sternum out toward your arm, you will feel a bump at the top, right above your shoulder. That is your AC joint.

AC joint separation or dislocation is a common upper extremity injury that occurs when someone falls directly onto the top of their shoulder. During this injury, the arm, and its attached scapula are forced downward, while the clavicle remains in place. This occurrence ruptures the ligaments between the scapula and the clavicle. The severity of the injury determines the number of these ligaments that are ruptured and determines our treatment.

Activities that yield the highest rates of AC joint injuries:

  • Skiing and snowboarding

  • Biking

  • Contact sports such as hockey, rugby and football

Signs and symptoms of AC injury:

  • Pain when lifting objects

  • Pain with overhead movement

  • Bruising and swelling on the shoulder

  • Tenderness

  • “Popping” of the shoulder blade

Though it is considered a traumatic event, AC dislocations usually don’t require surgery. In fact, VSON upper extremity specialist and surgeon Dr. Erik Dorf suffered an AC separation of his own, and didn’t require surgery!

“Every time a patient comes in to see me with this injury, I talk about my AC joint – which on x-ray is pretty bad, and in real life looks even worse,” said Dorf.

While Dr. Dorf’s injury might look abnormal, he no longer experiences any pain, nor does he suffer any adverse side effects resulting from the injury. He can throw a ball, do pullups, and ride bikes

without any issues.

Depending upon the severity of the injury, the operative and non-operative management of injuries like this can be very similar. In fact, many professional baseball pitchers are still working in the Major Leagues who have complete separation of all of the ligaments surrounding the AC joint, in their throwing arm, and they function just fine.

That being said, some AC injuries will reliably do better with surgery. Our experts can help you determine if your AC injury falls into this category.

We can determine the recovery time after an AC joint injury by the extent of the damage to the surrounding ligaments. While the timing for this recovery varies, most individuals heal in 6-8 weeks.

The recovery after surgery takes longer, and patients can typically expect some modifications in their activity levels for 3-6 months. That doesn’t mean that you are entirely out of commission for that time, but a reconstruction of the AC joint requires time to heal. Another crash or lifting of heavy objects can put that repair in jeopardy for quite some time.

If you suspect you might have injured your AC joint, it’s best to make an appointment immediately so that a Colorado sports medicine specialist can determine the proper next steps.


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