Neck & Shoulder

What It Is

The acromioclavicular (AC) joint tends to be injured most often when someone falls directly onto the point of the shoulder (American Academy of Orthopaedic Surgeons, n.d.). The trauma causes the acromion to separate from the collarbone (clavicle), which causes a sprain or a true dislocation. In cases of mild injury, the ligaments supporting the joint are stretched, classified as a Grade I injury. In more severe cases, ligaments can tear partially, known as Grade II, or tear completely, known as Grade III. In the more severe injuries, the end of the collarbone sticks up under the skin and is easily seen as a bump (American Academy of Orthopaedic Surgeons, n.d.).

AC joint sprain may also be known as an AC joint separation.

AC joint sprains often occur in contact sports such as rugby and hockey (Nolte et al., 2020), and can also happen in falls during snow sports such as skiing and snowboarding.

Minor AC joint injuries can be difficult to diagnose, but there will be point tenderness over the tip of the shoulder, and you will usually have pain and difficulty taking your arm across your chest past your opposite shoulder.

Acromioclavicular Joint Sprain Anatomy

The top part of the shoulder blade is known as the acromion. The acromion is the "tip" of the shoulder. If you look at the shoulder, it looks like a small protrusion at the top. Following a rupture of the ligaments, however, the end of the collarbone can look quite prominent.

The joint that is formed where the acromion connects with the collarbone is known as the acromioclavicular joint. Like most of the other joints in the body, the bone ends are covered with cartilage, and there is cartilage between the collarbone and the acromion. The joint is held together by a capsule and the AC ligaments, while the collarbone is held in position by strong ligaments known as the coracoclavicular (CC) ligaments (American Academy of Orthopaedic Surgeons, n.d.; Nolte et al., 2020).

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat an Acromioclavicular Joint Sprain

For a minor (grade I to II) injury, I can help with hands-on treatment and a gradual exercise programme to get your shoulder moving and strong again. If the injury is more severe, see your family doctor or nurse practitioner first. See the My Approach tab for how I work.

1. Ice

Applying a cold pack to the point of the shoulder can help to ease pain. Wrap an ice pack or frozen peas in a damp towel and apply for up to 15 minutes every few hours (University Hospitals Sussex NHS Foundation Trust, 2026). Never put ice directly on your skin.

2. Sling

Using a sling can help with comfort by taking some of the weight of your arm. It is there to help with pain rather than to speed up healing, and you should come out of it gradually over 2 to 3 weeks as the pain improves (Chelsea and Westminster Hospital NHS Foundation Trust, n.d.). You do not need to wear it at night (University Hospitals Sussex NHS Foundation Trust, 2026).

3. Gentle Movements

Gently moving the arm can help to prevent stiffness. Start straight away by gently moving your fingers, wrist, elbow and shoulder. These exercises should not cause too much pain, so do fewer if they are making your pain worse (University Hospitals Sussex NHS Foundation Trust, 2026). Use the shoulder as much as the pain allows (Chelsea and Westminster Hospital NHS Foundation Trust, n.d.).

4. Medication

University Hospitals Sussex NHS Foundation Trust (2026) advises taking painkillers, following the instructions on the packet, if you are in pain after a minor AC joint injury. (This medicine information comes from University Hospitals Sussex NHS Foundation Trust, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

Treatments you may want to discuss with your family doctor or nurse practitioner

Options outside my scope

Surgery: an operation may be considered if pain continues or the deformity is severe, for example to trim the end of the collarbone or to reconstruct the ligaments (American Academy of Orthopaedic Surgeons, n.d.). Some people go on to have ongoing pain when straps press on the joint, or catching, clicking or pain with overhead activities like throwing, reaching or lifting. If you have surgery, follow your surgical team's own instructions about lifting and exercises afterwards.

How I can help (see the My Approach tab)

Hands-on treatment for the shoulder, neck and upper back
Exercises to get the shoulder moving and build strength around the joint
Advice on your sling, lifting and getting back to sport

Tips

A minor (grade I to II) AC joint injury usually takes 3 to 6 weeks to heal, but you may have symptoms for 3 to 6 months (University Hospitals Sussex NHS Foundation Trust, 2026). Occasionally the injury does not settle even after several months (Chelsea and Westminster Hospital NHS Foundation Trust, n.d.).
A bump at the end of the collarbone may remain once the injury has healed; this does not usually affect what you can do (University Hospitals Sussex NHS Foundation Trust, 2026).
Arthritis can develop in the joint later on, even after a minor injury, causing aching, stiffness and even swelling (Chaudhury et al., 2018).
Young people lifting heavy weights can develop problems at the end of the collarbone (Chaudhury et al., 2018).
After a minor injury, avoid heavy lifting for about six weeks (University Hospitals Sussex NHS Foundation Trust, 2026).

Treatment

My Approach

An AC joint sprain is a stretch or tear of the ligaments holding the collarbone to the shoulder blade. No muscles cross the joint itself, so my aim is to settle the pain, keep the rest of your shoulder moving, and build up the muscles around it so they support and control the area.

Which path we take depends on how bad the injury is.

If it's a mild sprain (grade I or II): the ligaments are stretched or partly torn, and I can treat it directly, as below.

If it's a severe injury (grade III or higher): the ligaments are fully torn. See your family doctor or nurse practitioner first so it can be checked and a plan made. I then provide supportive care within your medical team's limits, and if you've had surgery I need your surgeon's okay before any hands-on treatment.

I start by assessing where it's tender, how far and how comfortably you can move your arm, the strength of your shoulder and shoulder-blade muscles, and your neck and upper back.

When It's Sore

Easing the neck, upper back and shoulder-blade muscles that tighten up to guard the shoulder
Gentle, pain-free movement for the main shoulder joint so it doesn't stiffen
Warm or cool applications in the clinic, and I'll show you how to use ice safely at home
Advice on coming out of your sling, sleeping and everyday tasks
Taping to support the shoulder in the short term, if it helps

As It Settles

Cross-fibre work over the irritated ligaments once they're past the early, sore stage
Gentle joint mobilisation for the shoulder and shoulder blade, within a comfortable range, if they've stiffened
Strength work for the shoulder-blade and shoulder muscles, from light holds to fuller movement
A home programme to do between visits
A step-by-step return to lifting and sport, including gym-based work

After Surgery

Following your surgeon's protocol: the arm stays protected, and we only move it as far as you've been cleared for, while keeping the wrist, hand and elbow moving
Scar work once the wound has healed, then a gradual return to strength

If the pain gets much worse, or you notice numbness or weakness in your arm, see your family doctor or nurse practitioner.

What to Expect

Typical Course

Typical course: For a mild sprain, most people come once or twice a week at first, then weekly as we build strength, with a reassessment at about 4 to 6 weeks; it usually heals in 3 to 6 weeks, though you may notice it for 3 to 6 months, and heavy lifting usually waits about six weeks. For a severe injury, your medical team sets the timeline: after surgery the arm is usually protected for about the first six weeks, then visits and loading follow your surgeon's plan, often over several months.

What I Focus On

Assessment

Shoulder Mobility

Ligament Frictions

Shoulder-Blade Strength

Gradual Return to Lifting & Sport

Sources

References

American Academy of Orthopaedic Surgeons (n.d.) Shoulder separation. OrthoInfo. Available at: https://www.orthoinfo.org/en/diseases--conditions/shoulder-separation/ (Accessed: 7 October 2026).
Nolte, P.C., Lacheta, L., Dekker, T.J., Elrick, B.P. and Millett, P.J. (2020) 'Optimal management of acromioclavicular dislocation: current perspectives', Orthopedic Research and Reviews, 12, pp. 27–44. doi: 10.2147/ORR.S218991
University Hospitals Sussex NHS Foundation Trust (2026) Minor injury to acromioclavicular joint (ACJ grade 1 to 2 injury). Available at: https://www.uhsussex.nhs.uk/resources/minor-injury-to-acromioclavicular-joint-acj-grade-1-to-2-injury/ (Accessed: 7 October 2026).
Chelsea and Westminster Hospital NHS Foundation Trust (n.d.) Acromio-clavicular joint (ACJ) injury. Available at: https://www.chelwest.nhs.uk/your-visit/patient-leaflets/surgery-services/acromio-clavicular-joint-acj-injury (Accessed: 7 October 2026).
Chaudhury, S., Bavan, L., Rupani, N., Mouyis, K., Kulkarni, R., Rangan, A. and Rees, J. (2018) 'Managing acromio-clavicular joint pain: a scoping review', Shoulder & Elbow, 10(1), pp. 4–14. doi: 10.1177/1758573217700839

Massage therapy · Kitchener–WaterlooAcromioclavicular Joint Sprain

What It Is

Acromioclavicular Joint Sprain Anatomy

Self-Care & Treatment

How to Treat an Acromioclavicular Joint Sprain

1. Ice

2. Sling

3. Gentle Movements

4. Medication

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

When It's Sore

As It Settles

After Surgery

Typical Course

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooAcromioclavicular Joint Sprain

What It Is

Acromioclavicular Joint Sprain Anatomy

Self-Care & Treatment

How to Treat an Acromioclavicular Joint Sprain

1. Ice

2. Sling

3. Gentle Movements

4. Medication

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

When It's Sore

As It Settles

After Surgery

Typical Course

References

Related Conditions

Biceps Brachii Tendinopathy

Biceps Tendonitis of the Shoulder

Calcific Tendinopathy of the Shoulder

Glenohumeral Joint Osteoarthritis

Book a session