AC Joint Rehabilitation Phase 1: Early mobilisation and pain reduction

The AC Joint (AKA: ACJ/ Acromio-clavicular joint) is a commonly-damaged joint in the shoulder. The joint can easily be felt by running your fingers outwards along your clavicle bone until you feel the bone-end, with damage to the joint causing pain that is usually very localised to this area. An ACJ injury can be diagnosed usually by a) observing a new boney-lump on the shoulder or b) experiencing pain when bringing your arm straight out to 90 ahead of you and then bringing it across your body.

Early Treatment
Keep the shoulder as mobile as possible after injury and only immobilise if in excessive pain. Ice regularly for 20mins at a time every couple of hours and begin the following exercises as soon as possible.

Type
Early movement exercises that will improve the shoulder range and also help reduce pain.

Suitable for
Those who have recently sustained an AC joint injury.

Equipment
A small sturdy object such as an umbrella/broom handle.

Repetitions and sets

Perform the workout for small periods (15-20min) several times a day. Increase stresses gradually as pain allows.

The Workout
1. Rocking-assisted abduction Bend the elbow of the injured arm to 90 degrees and bring it cross the body. Support it with the other arm so that the supporting hand is under the elbow. Begin to slowly rock both arms side to side, moving as far as pain allows. Range can be increased by moving the supporting hand further along the forearm of the injured side until your hands are together. 2. Pendular Progression Lean forward and support yourself with your good arm against a table. Allow your injured arm to drop down with gravity. Gently begin to swing the injured arm side-to-side as pain allows. Repeat this sideways movement for 30 seconds several times. In-between each one, change the movement so you are making circles with your arm. Make the circles as big as you are able. 3. 1.c Assisted Progression Sit upright in a chair with your injured arm bent at the elbow so that the elbow is by your side and that the hand is resting on the same-side chest. Support the elbow with the good hand, and gradually lift it out to the side as far as pain allows. 4. Rocking-assisted flexion Begin sat down with both arms again folded across the body, with the injured side supported over the uninjured arm. Lean forwards as far as you are able and repeat the rocking motion, this time moving out in front of you and back against your chest.

5. Pendular Progression Lean forward parallel with the edge of a table so that the good side is closest to it and support yourself with your good arm. Let your injured arm hang with gravity before gradually beginning to rock it backwards and forwards as far as pain allows. Lean over further to get an increase in range. After performing for 30 seconds, follow by drawing imaginary circles with your hand. Make the circles as large as you are able. 6. Assisted Progression Sit upright in a chair with your injured arm bent at the elbow so that the hand is doubled back and above your injured shoulder Support the injured arm by placing your other hand under the elbow. Keeping your shoulders set back and chest out, lift the elbow up and out in front of you as far as the pain will allow. During this movement allow your hand to move down the back of your shoulder. 7. External Rotation Bend the injured arm at the elbow to 90 degrees. Keep the elbow secure against the side of your waist and support the bent forearm at the wrist with the good hand. Keeping the elbow against the side of your body, Gradually move the forearm outwards as far as pain allows. Get greater range by holding closer to the elbow. Progress the exercise by using a small pole (a ruler/umbrella etc..) and holding it in both hands before gradually encouraging the injured arm to rotate outwards. 8. Internal Rotation Begin again with the injured-side elbow against your waist and bent to 90 degrees. Supporting the arm at the wrist with the good hand, and keeping the elbow stationary, pull the hand across until it is able to touch your chest without pain. Once you are able to do this comfortably, Progress by starting with the injuredside hand pressed against your body where the previous movement ended. Keeping the hand stationary, Reach around over the arm with the good hand and securely grasp the elbow. Pull the elbow out away from the body as far as you are able.