AC Joint Separation Rehab Protocol: A Comprehensive Guide

Introduction

An AC joint separation is a common shoulder injury, especially among athletes and active individuals. Whether caused by a fall, direct impact, or overuse, this condition can be painful and limit shoulder mobility. Proper rehabilitation is crucial for recovery and preventing long-term complications. This guide provides a structured AC joint separation rehab protocol to help you regain strength, flexibility, and function effectively.

Understanding AC Joint Separation

What is AC Joint Separation?

The acromioclavicular (AC) joint connects the clavicle (collarbone) to the acromion of the scapula (shoulder blade). When the ligaments stabilizing this joint are damaged, it results in joint separation, classified into different grades based on severity.

Classification of AC Joint Injuries

• Grade I – Mild sprain with minimal pain and no displacement.
• Grade II – Partial ligament tear with slight clavicle displacement.
• Grade III – Complete ligament tear with significant displacement.
• Grades IV-VI – Severe cases requiring surgical intervention.

AC Joint Separation Rehab Protocol

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

Goals:

• Reduce pain and swelling
• Protect the injured area
• Maintain range of motion in adjacent joints

Rehabilitation Steps:

• Rest and Immobilization: Use a sling to minimize movement and allow healing.
• 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 with discomfort (consult a doctor before use).
• Gentle Movements: Perform pendulum exercises to prevent stiffness in the shoulder.
• Posture Awareness: Maintain good posture to avoid unnecessary stress on the joint.

Phase 2: Early Mobilization (2-6 Weeks) – Regaining Motion

Goals:

• Restore shoulder range of motion (ROM)
• Begin strengthening surrounding muscles
• Reduce stiffness

Rehabilitation Steps:

• Active and Passive Range of Motion Exercises:
  • Shoulder shrugs and scapular retractions
  • Wall slides to encourage gradual mobility
• Stretching Exercises:
  • Cross-body arm stretch
  • Doorway pec stretch
• Light Strengthening Exercises:
  • Isometric exercises to engage the shoulder muscles without excessive strain
  • Resistance band external rotations (as tolerated)

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

Goals:

• Strengthen rotator cuff and shoulder stabilizers
• Improve joint stability and endurance
• Restore full functional movement

Rehabilitation Steps:

• Progressive Strength Training:
  • Dumbbell lateral raises
  • Front raises
  • Theraband rows
• Proprioceptive Training:
  • Stability exercises using a balance board
  • Plank variations to engage core and shoulder stability
• Functional Movements:
  • Gradually introduce push-ups, overhead presses, and sport-specific movements
  • Emphasize controlled motion to avoid reinjury

Phase 4: Advanced Strength and Return to Activity (12+ Weeks)

Goals:

• Achieve full strength and mobility
• Return to normal activities and sports
• Prevent reinjury

Rehabilitation Steps:

• Higher Resistance Training:
  • Incorporate heavier weights and compound movements
  • Perform plyometric exercises for explosive strength
• Sport-Specific Drills:
  • For athletes, simulate game movements to prepare for return
  • Gradually reintroduce throwing, lifting, or overhead activities
• Ongoing Maintenance:
  • Continue stretching and mobility drills
  • Maintain proper shoulder mechanics to prevent future injuries

Tips for a Successful Recovery

• Listen to Your Body: Avoid activities that cause sharp pain.
• Stay Consistent: Follow the rehab protocol diligently.
• Seek Professional Guidance: A physical therapist can ensure proper technique and progression.
• Modify Workouts: Adjust intensity based on your comfort level.
• Stay Patient: Recovery varies based on injury severity and individual factors.

Conclusion

Rehabilitating an AC joint separation requires a structured and progressive approach to restore full shoulder function safely. By following this step-by-step rehab protocol, you can minimize pain, regain strength, and prevent reinjury. If symptoms persist or worsen, consult a healthcare professional for personalized guidance.

Need expert advice? Reach out to a physical therapist for a tailored rehab plan and faster recovery!