AC Joint Rehab Protocol: A Comprehensive Guide to Recovery

Introduction

The acromioclavicular (AC) joint is a small but critical part of the shoulder complex, connecting the clavicle (collarbone) to the acromion of the scapula (shoulder blade). Injuries to the AC joint, commonly known as AC joint sprains or separations, can result from direct trauma, falls, or sports-related impacts. Proper rehabilitation is essential to restore function, reduce pain, and prevent long-term complications.

This guide outlines an effective AC joint rehab protocol, covering the different stages of recovery, exercises, and key considerations for a safe and successful return to activity.

Understanding AC Joint Injuries

Types of AC Joint Injuries

AC joint injuries are classified into six grades based on severity:

• Grade I: Minor sprain with slight discomfort and no displacement.
• Grade II: Partial ligament tear causing mild separation.
• Grade III: Complete ligament rupture leading to visible deformity.
• Grades IV-VI: Severe dislocations requiring surgical intervention.

Symptoms of AC Joint Injury

• Pain and tenderness at the top of the shoulder
• Swelling and bruising around the joint
• Limited range of motion and weakness
• Noticeable bump (in severe cases)

AC Joint Rehab Protocol: Step-by-Step Recovery

Phase 1: Acute Phase (0-2 Weeks) – Pain Management and Protection

Goals:

• Reduce pain and inflammation
• Protect the joint from further injury
• Maintain mobility in surrounding areas

Treatment & Exercises:

• Rest and immobilization: Use a sling for support (if necessary) to minimize movement.
• Ice therapy: Apply ice packs for 15-20 minutes every 2-3 hours to reduce swelling.
• Pain management: NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) can help alleviate discomfort.
• Gentle range of motion exercises: Perform pendulum swings and scapular retractions to prevent stiffness.

Phase 2: Early Rehabilitation (2-6 Weeks) – Restoring Mobility

Goals:

• Improve range of motion
• Begin gentle strengthening
• Reduce reliance on sling

Treatment & Exercises:

• Passive and active-assisted range of motion exercises:
  • Shoulder flexion and abduction (with assistance if needed)
  • Wall walks to gently stretch the joint
• Isometric exercises for stability:
  • Isometric shoulder abduction and external rotation (press against a wall without movement)
• Postural exercises:
  • Scapular stabilization drills to promote proper shoulder mechanics

Phase 3: Strengthening Phase (6-12 Weeks) – Building Strength and Stability

Goals:

• Strengthen shoulder muscles
• Improve joint stability
• Restore full range of motion

Treatment & Exercises:

• Resistance training:
  • Theraband external and internal rotations
  • Dumbbell lateral raises (light weight, controlled movement)
• Functional movements:
  • Push-ups against a wall progressing to knee push-ups
  • Farmer’s carry (holding weights to build endurance)
• Proprioceptive exercises:
  • Single-arm holds with resistance bands
  • Stability ball movements to enhance neuromuscular control

Phase 4: Advanced Strengthening (12+ Weeks) – Returning to Activity

Goals:

• Regain full strength and endurance
• Return to sport or daily activities safely

Treatment & Exercises:

• Sport-specific drills (if applicable)
• Plyometric exercises:
  • Medicine ball throws
  • Clapping push-ups for explosive strength
• Weight training with progressive overload (under professional guidance)
• Gradual return to normal activities with pain-free movement

Key Considerations for a Successful Recovery

Avoiding Common Mistakes

• Skipping early rehab exercises – Leads to stiffness and prolonged recovery.
• Overloading too soon – Pushing too hard can cause setbacks.
• Ignoring posture and shoulder mechanics – Poor form can lead to chronic instability.

When to Seek Professional Help

• Persistent pain beyond 8-12 weeks
• Severe weakness or inability to lift the arm
• Signs of re-injury, such as swelling or deformity

Conclusion

Recovering from an AC joint injury requires patience, consistency, and a well-structured rehab plan. By following this step-by-step protocol, you can gradually restore mobility, strength, and function, ensuring a safe return to daily activities or sports.

If you’re experiencing prolonged pain or difficulty, consult a physical therapist or orthopedic specialist for a personalized treatment plan. Stay proactive in your recovery, and you’ll be back to full strength in no time!