Howard J. Levy, M.D.: Nonsurgical: Acromioclavicular (AC) Separation

	Overview The pain and discomfort experienced with an AC Joint separation can vary based on the severity of the injury. The shoulder joint capsule, ligaments and muscles are all affected by this injury; each of these structures heal at different rates and to different extents. Non-surgical AC separations are usually classified as grades I-III; however, the surgical/non-surgical treatment decision of a grade III seperation depends upon the judgement of the physician.
	Rehabilitation Program Non-surgical treatment initialy focuses on range of motion, followed by strengthening and weight training. Stretching Week 1: Passive range of motion No limit for forward elevation, external rotation or internal rotation. Week 2-3: Active range of motion with terminal stretch Forward elevation External rotation Internal rotation Strengthening Week 4 onward (if pain permits): Resistance training and stretching Continue above stretches Elastic resistance exercises Scapular exercises: shrugs, rows Forward flexion/punch Biceps curls

Long-Term Expectations for Recovery Patient's goals and lifestyle may need to be altered, with normal activity levels being modified. Sustaining a complete recovery is dependent on the severity of the injury, the health and habits of the patient and underlying shoulder disorders or conditions. Maintaining an active exercise program is the best recommendation for recovery.
Possible Complications and Risks The development of an unstable or arthritic AC joint. Delayed healing may occur if shoulder activities are begun to soon or too vigorously after injury. Participation in repetitive motion activities like football, tennis, and baseball increase the risk for recurrence of pain in the AC Joint. Recurrent inflammation at the point where the muscle attaches to bone.
Doctor's Notes