What we treat Shoulder
AC Joint Separation
An acromioclavicular (AC) joint separation is a common shoulder injury, often resulting from a direct fall onto the shoulder. It occurs when the ligaments connecting the collarbone to the shoulder blade are stretched or torn, leading to pain and a visible 'step-off' presentation at the top/outside of the shoulder.
Common Symptoms
Sharp or aching pain specifically at the top of the shoulder where the collarbone meets the shoulder blade.
A noticeable step-off or swelling at the AC joint, often more prominent when looking from the side or front.
Difficulty and pain when lifting the arm overhead or reaching across the body to the opposite shoulder.
How to Diagnose It in Physical Therapy
Diagnosis is the first step toward effective recovery. Our physical therapists use a combination of physical examination and clinical testing to confirm the degree of AC joint separation.
We check for the characteristic 'step-off' deformity, localized swelling, and bruising around the acromion and clavicle.
Direct pressure is applied to the AC joint and surrounding ligaments (coracoclavicular) to determine the exact site of pain and ligamentous instability.
We utilize the Cross-Body Adduction test and the Paxinos sign, which are validated clinical clusters used to identify joint-specific pain with high sensitivity.
Functional screens are performed to monitor how the joint handles vertical loading, helping determine if surgical referral or conservative care is the best path forward.
01
Initial phase focused on unloading the joint using taping and gentle manual therapy and light passive or active assisted range of motion exercises.
02
Progressively restoring shoulder range of motion and initiating scapular stability without straining the AC ligament.
03
Strengthening the muscles that control the shoulder blade to provide mechanical support.
04
Gradual return to lifting and overhead sports through controlled load exposure.
Our data-driven approach ensures that every step is timed perfectly to your body's healing progress, minimizing the risk of re-injury and maximizing long-term stability.
Exercises to Start With
Safety is our top priority. These mobility and strengthening exercises are designed for the early stages of recovery to restore movement quality without stressing the joint.
Shoulder Pendulums - Gently lean forward and let your arm hang. Use your body to create small circles, allowing gravity to provide gentle traction.
Shoulder Isometrics - Keep your elbow at your side and press your forearm into a wall. Hold for 5-10 seconds to engage stabilizing muscles.
Scap Squeezes - Gently pull your shoulder blades back and down towards each other. Focus on control rather than force.
Tell us what you want to return to?
This page is general information, not a diagnosis. If it sounds like what you have, an evaluation is where we find out properly.