AC Joint Sprain

Protection → Controlled Motion → Return to Function

What AC Joint Sprain Is

An AC joint sprain — a 'shoulder separation' — is an injury to the small joint on top of your shoulder where the collarbone meets the shoulder blade, usually from a fall onto the shoulder or an outstretched hand. It causes pain and often a bump right on top of the shoulder. Lower grades heal well with protection and progressive strengthening.

Primary — Lower-grade sprain — pain and tenderness right on top of the shoulder, sometimes a small bump, but the shoulder is stable and usable. This protocol is for it.
Secondary — Higher-grade separation — a large, obvious deformity or a very unstable shoulder after trauma needs assessment, as some grades are managed differently.

Involved tissues: The acromioclavicular (AC) joint on top of the shoulder and its ligaments, where the collarbone meets the shoulder blade, plus the surrounding deltoid and trapezius muscles.

Two pillars for an AC sprain: first, protect the joint early — a sling for comfort in higher grades, and avoid the positions that stress it (reaching across the body, heavy overhead, lying on it); second, progressively restore motion and strengthen the deltoid, cuff, and scapular muscles that support the joint. Protect it, then build the support around it.

Protect it, then build around it

The AC joint is a small joint that takes a lot of load from the arm, and after a sprain it's sore and reactive — but the surrounding muscles (deltoid, trapezius, cuff, and scapular stabilizers) can take a lot of the load off it as it heals. So early on we protect it (a sling for comfort in higher grades) and avoid the movements that directly stress it — reaching across the body and heavy overhead work — while keeping the rest of the shoulder moving. Then we progressively strengthen the muscles around the joint so the shoulder is stable and strong. Most lower-grade separations do very well this way.

⚠️ Screen Before You Start — Get Assessed First If You Have:

●A large, obvious deformity or a very unstable shoulder after the injury
●Severe pain, numbness, or a cold or pale arm or hand
●Inability to move the arm at all, or a possible fracture after a hard fall
●Skin tenting or broken skin over the bump
●Severe pain unrelieved by rest or positioning

This is education, not a diagnosis, and doesn't replace hands-on care.

🌡️ Finding your stage

Take your movement temperature. Painful, reactive, hard to reach overhead or across = Protection. Settling, restoring motion = Controlled Motion. Comfortable and ready for strength and load = Return to Function. The win is a pain-free, strong shoulder that handles overhead and cross-body loads. Re-check every session.

Phase 1 · Acute

Protection Phase

🌡️ Painful · reactive · hard to reach across/overhead

Goal: Protect the joint and calm it while keeping the rest of the shoulder moving.

Manual treatment: Pain-relief modalities and gentle pain-free motion.

Frequency: Daily · gentle sessions.

A. Protect & Calm

SoftWave Therapy

Video coming soon

Dose: As scheduled
How: Applied to the joint to calm symptoms and stimulate healing.
Watch for: The anchor of the early phase.

Protect & Activity Modification

Video coming soon

Dose: Ongoing
How: A sling for comfort in higher grades, avoid lying on it, and avoid reaching across the body and heavy overhead work early.
Watch for: Cross-body reaching and heavy overhead directly stress the AC joint — avoid them early.

B. Gentle Motion

Pendulums

Video coming soon

Dose: 2–3 min
How: Relaxed arm circles to keep the shoulder moving without loading the joint.
Watch for: Arm relaxed and heavy — gentle motion only.

Pain-Free ROM

Video coming soon

Dose: 5–10 reps
How: Move through the ranges that don't stress the AC joint.
Watch for: Avoid the painful cross-body and overhead positions.

Protect the joint — avoid cross-body reaching and heavy overhead loading early, which directly stress the AC joint. Keep the rest of the shoulder moving.

✅ Ready for the next phase when:

Pain is settling and gentle motion is comfortable.

Tracking Your Progress

The weekly stability check: am I better, the same, or worse than last week?

Better

Stay the course; progress load as pain shrinks and motion returns.

Same

Change the load or drill; confirm the surrounding muscles are strengthening.

Worse

Drop back a phase; if there's deformity, instability, or severe pain, get assessed.

The Rules That Govern This Protocol

1Protect the joint early — avoid cross-body and heavy overhead loading while it heals.
2Strengthen the muscles around the joint (deltoid, cuff, scapula) to support it.
3Reintroduce overhead, pressing, and contact loads gradually.
4No lasting increase in pain after a session.

Movement You Love Is Therapy. This protocol is general education based on course rehabilitation materials and standard principles. It is not medical advice, diagnosis, or treatment, and does not create a provider–patient relationship. If pain is severe, worsening, or unexplained, see a licensed provider.