Shoulder condition
AC joint injuries
Sprains and separations of the small joint where the collarbone meets the shoulder blade.
The acromioclavicular, or AC, joint sits at the top of the shoulder. A direct fall onto the shoulder can stretch or tear its supporting ligaments. Most low-grade injuries recover without surgery, while severe displacement, persistent symptoms, and individual work or sport demands may change the plan.
See the anatomy and imaging
What is injured
The AC ligaments stabilize the joint itself. The coracoclavicular ligaments help suspend the shoulder blade from the collarbone. A mild sprain stretches these structures; a higher-grade separation can tear them and allow the collarbone and shoulder blade to move apart.
Diagnosis and grading
The history and examination usually identify the problem. X-rays compare alignment and look for a fracture. Injury grade describes the direction and amount of displacement, but symptoms, skin condition, occupation, sport, and response to early care also guide treatment.
Nonsurgical care
- A sling for comfort for a limited period
- Ice and pain medication when appropriate
- Early elbow, wrist, and hand motion
- Gradual shoulder motion followed by strength and return to activity
When surgery may help
Surgery is uncommon for low-grade injuries. It may be considered for severe displacement, threatened skin, certain high-demand patients, or persistent pain and dysfunction after healing. Reconstruction restores the relationship between the collarbone and coracoid using ligament graft, strong sutures, or fixation selected for the injury.
Recovery
Nonsurgical recovery may take several weeks, with the bump often remaining even when function returns. After reconstruction, the repair is protected in a sling before progressive motion and strengthening. Heavy lifting and contact activity generally return over several months.
Seek prompt evaluation
A new deformity, severe pain, numbness, an open wound, or pale or cool hand after an injury needs prompt medical assessment.
Evidence and further reading
Educational content is reviewed for patient clarity and is not a substitute for an examination or individualized medical advice.
PIA Shoulder MD