AC Joint Shoulder Pain

The Acromioclavicular joint (AC Joint) is the joint at the top of your shoulder between your clavicle (collarbone) and your scapula (shoulder blade) Refer here for image. The AC joint allows for overhead and across body shoulder movements.

AC Joint Sprain

A common injury we treat at Trained Physio East Perth is the AC joint sprain, which consists of ligament over-stretching.  The degree of AC joint ligament damage can vary from a mild strain of one or more of the surrounding ligaments, to a complete ligament tears and deformity.

Causes of AC Joint Sprain

Direct impact/trauma can cause serious injury to your AC joint.  For example; When a person collides with a solid object or surface, such as a fall from a bicycle or more common presentations we treat in our East Perth Physio clinic are sports related injuries from tackeling, where the shoulder hits the ground.  The force transmitted up the arm forces a separation of the acromion and clavicle, causing the ligaments to overstretch and become damaged in the process.

Symptoms of AC Joint Sprain

  1. Pain on the top of the shoulder aggravated by heavy lifting, overhead and across body movements
  2. Swelling +/- bruising
  3. Loss of shoulder movement
  4. Sometimes a hard, visible lump may also be present on the top of the shoulder, indicating the displacement of the clavicle (collar bone)

AC Joint Injury is Graded by Severity:

Grade 1 (minimal joint disruption) to Grade 3 (severe damage)

If the injury is the more severe, Grade 3 and above, surgery may be requested.  Your East Perth Physio may refer you off for an x-rays to ensure there are no fractures of the clavicle or scapula.

Treatment of AC Joint Sprain


Most patients with an acromioclavicular joint injury start to feel better within a few days or a week after the initial injury.  However, full ligament healing can take at least six weeks.

Your Physiotherapy treatment will aim to:

  1. Reduce pain and inflammation
  2. Normalise joint range of motion
  3. Strengthen your shoulder
  4. Normalise your muscle lengths
  5. Improve your technique and function, e.g. lifting, overhead activities
  6. Minimise your chance of re-injury as you return to sport or work


In severe cases, some patients choose to undergo AC joint surgery to pin the AC joint or repair the damaged ligaments surrounding the AC joint.  Post-operative rehabilitation is one of the most important, yet too often neglected, aspects of surgery.  The quickest and most successful outcomes result from the guidance and supervision of an experienced shoulder physiotherapist.  Your rehabilitation following shoulder surgery focuses on restoring full shoulder motion, strength, power and endurance.

Return to sport

When returning to your sport, you must undergo a graduated transition to avoid the risk of injury recurrence.  This rehabilitation includes completing a full individually designed rehabilitation program aimed at improving strengthening, flexibility and proprioception in your upper limbs.

As a general guide the return to play will be:

Gr 1: 0-2wks

Gr 2: 2-4 wks

Gr 3: 4-8 wk

How Trained Physio Can Help!

As the head Physio for Wests Scarborough Rugby Club I see many AC joint injuries every week as well as in our East Perth Trained Physio clinic – all of our Physio’s have a special interest and experience working with shoulder injuries and you can expect the following:

  1. Assess and treat muscular weaknesses
  2. Injury assessment and diagnosis
  3. Addressing the cause of the injury
  4. Manual therapy or dry needling and other specific injury treatment
  5. Exercise rehab and return to training plan
  6. Training modifications to prevent you from stopping training
  7. Helping you remain injury free
  8. Assessment of technique optimisation

East Perth Trained Physio

Did you know at Trained Physio we have a fully equipped rehabilitation facility?  Check out the details here.  Physiotherapy has several goals including promote healing, reduce pain, avoiding aggravation, optimising physical function and global strengthening to restore normal movement patterns.  To see how I can help you BOOK ONLINE TODAY

Written by: Matthew Finberg

BSc. Physiotherapy
Masters in Sports Physiotherapy (currently)
Masters in Exercise Rehabilitation Science