AC Joint Sprain/Dislocation Fractured clavicle (collar bone)

What Is It?

A sprain of the acromioclavicular joint (ACJ) or fractured clavicle is when the end of the collar bone is injured or broken often at the point where it joints the scapula (shoulder blade). Most people injure this area by falling onto the end tip of the shoulder or sometimes an outstretched arm.

What causes the sprain or fracture?

The ACJ is a lot like the outside of the ankle because it has 3 main ligaments that hold the clavicle to the scapula. When you land on your shoulder you can tear or sprain one, two or all three of these ligaments. Without the ligaments holding your clavicle down the end of the bone sits up higher and you could see a step deformity.

If the force from landing is greater than your joints can handle you may fracture your clavicle. This often occurs approximately 1/3rd of the way down the clavicle at the weakest point.

What does it feel like?

An ACJ sprain or fractured clavicle will feels very painful at the tip of the shoulder at the time of injury. Afterwards you may only feel pain when you try to move your arm above in any direction especially higher than 90°. Lying on the side or leaning on anything with that arm will also cause a lot of pain. You will probably feel better with your arm in a sling or supported under the elbow by your other hand.

How is it diagnosed?

Your physiotherapist can diagnose your ACJ injury from your symptoms, mechanism of injury, looking and feeling where your deformity is the clavicle and with some simple tests. Most people are aware of which injury they have but will not know the extent of damage until further investigations are performed. Depending on the symptoms eg if you are getting pain down your arm or pins and needles, your therapist may refer you for X-ray to determine the extent of the damage.

How can Back in Action Physiotherapy help?

At Back in Action we will promptly diagnose your injury and refer if needed. We will help regain full movement in your neck and shoulder with mobilisations, massage, acupuncture and stretching.  A progressive strengthening programme is vital for regaining full function in your shoulder so we will create a personalised strengthening programme for you including scapula retraining and shoulder strengthening. Painkillers and Anti-inflammatories can help to relieve some pain and we recommend you see your local Pharmacist or Doctor regarding the best type for you. There are a very small number of clavicle fractures that require surgery which inserts a plate next to the bone. Your Back in Action physiotherapist will refer you directly to the surgeon if they think this could be needed.