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Physical Therapy for AC Joint Separation – Information, Exercises, and More

If you’ve recently injured your acromioclavicular (AC) joint—or think you may have—then you’re probably experiencing pain, swelling, and a loss of strength in your shoulder.

You may be wondering if surgery is in your future.

Luckily, AC joint rehab usually consists of physical therapy alone, avoiding surgery altogether. But, the key is to get your injury diagnosed as soon as you feel pain.

In this article, we break down everything you need to know about acromioclavicular joint physical therapy and what you can expect from your recovery.

What is AC Joint Separation?

Your clavicle (collarbone) and the acromion (shoulder blade) are held together by four ligaments. 

AC joint injury or separation describes the stress on these ligaments that results in some form of separation.


These injuries can be classified as mild to severe—depending on the level of trauma and detachment.

The two types of AC joint injuries that can occur are:

  • Traumatic
  • Overuse

Men under the age of 35 are the most commonly diagnosed with AC joint injury, due to the participation in contact sports and high-risk activities.

What Causes AC Joint Separation?

Shoulder pain affects approximately 13 million Americans every year and 31% of those are suffering from AC joint pain, either as a result of trauma or overuse.

Traumatic AC Joint Injury

Traumatic AC joint injury is most common in people who experience a hard fall and land on their hand or the top of their shoulder.

For example:

  • When a football player is tackled
  • When a downhill skier takes a tumble
  • When a cyclist falls off his or her bike
  • When a painter falls from a ladder

Overuse AC Joint Injury

When excessive demand is placed on the AC joint for an extended period of time, the cartilage that protects the bones can become stressed. Cartilage that sustains significant stress and wear is known as arthritis. 

This can occur in individuals who engage in repetitive activities that involve stretching the arms over the head. 

For example:

  • Weightlifters
  • Painters 
  • Manual laborers

AC Joint Separation Symptoms

If you sustain an AC joint injury, you may experience:

  • Pain and swelling
  • Tenderness over the AC joint
  • Loss of strength and motion in the shoulder
  • Popping sound or a catching feeling when moving the shoulder
  • A noticeable bump on top of the shoulder
  • Discomfort in the shoulder when lifting, reaching or carrying objects

A physical therapist can identify and treat AC joint injuries. You may be required to have diagnostic imaging tests to determine the extent of the injury, such as:

  • X-ray
  • MRI
  • Ultrasound

Your physical therapist will conduct a couple of different tests and will ask you to demonstrate the movement and activities that cause discomfort. 

The examination will include surrounding areas of the body, such as the neck and back, to determine how they may be contributing to the injury.

AC Joint Separation Treatment

Treatment for AC joint separation depends on the severity of the injury. 

Once a diagnosis is made, your therapist will work with you to develop an individualized treatment plan.

Grade 1 AC Joint Separation: Physical Therapy Protocol

If you sustain a grade 1 AC joint injury you may be required to:

  • Wear a sling for 5-7 days
  • Ice the injury for 48 to 72 hours
  • Take anti-inflammatory medication

As soon as symptoms begin to resolve, your physical therapist will structure a program that will focus on:

  • Range of motion 
  • Strengthening exercises
  • Manual therapy
  • Functional training
  • Patient education

Most patients can expect to return to normal activities within two weeks.

Grade 2 AC Joint Separation: Physical Therapy Protocol

Immediate treatment for grade 2 AC joint separation may include:

  • Wearing a sling for 1 to 2 weeks
  • Icing the injury for 48 to 72 hours
  • Taking anti-inflammatory medication

Once cleared for therapy, your physical therapist will structure your recovery plan based on the above treatments, but with a more extensive approach. 

Patients can expect to return to regular activities within two to three weeks.

Grade 3 AC Joint Separation: Physical Therapy Protocol

Immediate intervention for grade 3 AC joint injury involves the same treatments as grade 1 and 2 joint separation. 

It was previously recommended that grade 3 ac joint injuries should be treated surgically, however, the growing consensus among medical professionals is that physical therapy is just as effective. 

Your physical therapist will encourage gentle range of motion and isometric exercises, followed by a more structured physical therapy program.

Grade 3 AC joint separation physical therapy may last up to 8 weeks, or beyond, depending on the patient. 

Grade 4, 5, and 6 AC joint injuries usually require surgical intervention.

AC Joint Physical Therapy – Will PT Help?

If you’ve suffered from a traumatic or overuse injury of your AC joint, not only can a physical therapist diagnose the issue, but they will most likely be able to treat the separation without the need for surgery.

Depending on the extent of your injury, your physical therapist can help you return to your normal activities within as little as two weeks.

Immediate diagnosis and treatment are recommended for the best results.

Best AC Joint Exercises

Initially, all exercises should be guided and supervised.

AC joint recovery exercises may include:

  • Neck rotation
  • Shoulder rolls
  • Neck stretches
  • Shoulder blade squeeze
  • Laying down shoulder flexion
  • Standing shoulder extension
  • Goalpost stretch

Before engaging in any exercise program for AC joint rehab, it’s important to seek professional advice from a physical therapist.

How In Motion O.C. Can Help With AC Joint Separation

In Motion O.C. is a premier physical therapy facility with state-of-the-art equipment. 

Our physical therapists are the best in the business and have helped hundreds of individuals suffering from AC joint injuries.

We were voted #1 on Yelp for physical therapists in the entire country—see for yourself what our patients have to say about us.

We are the top choice for all sports, trauma, or health-related physical ailments. 

Don’t hesitate, call us today if you need AC joint physical therapy.

*This information about physical therapy for AC joint was reviewed by Dr Natalie Thomas, PT, DPT. If you have any questions, please don’t hesitate to contact us here.

In Motion O.C.