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Injury of the week - ACJ Dislocation

Symmetry Physio - Friday, May 17, 2019

As the Giro d'Italia gets underway we look at a common injury affecting cyclists.

 

Injury of the week - ACJ Dislocations

With the first of the 3 big grand cycling tours the ‘Giro d'Italia’ starting over the weekend we look at a common injury affecting cyclists ‘the acromioclavicular joint’ dislocation. This is injury results from a direct blow or fall onto the shoulder.

The ACJ is found at the end of the clavicle (collarbone) at the bony prominence called the acromion at the tip of the shoulder. The joint is stabilised by the acromioclavicular and coracoclavicular ligaments and the trapezius and anterior deltoid provide muscle support.

Symptoms of an ACJ dislocation include pain and swelling over the site, difficulty with shoulder movements and reduced strength. There may also be a deformity or ‘bump’ depending on the severity.

An ACJ dislocation is classified according to which ligaments are disrupted. An x-ray maybe used to view the degree of separation and rule out any fractures.

  • Type 1 involves a sprain of the acromioclavicular ligaments. The joint is painful but remains stable. A sling maybe required for comfort for a few days before early range of movement begins.
  • Type 2 involves torn acromioclavicular ligaments and a sprain of the coracoclavicular ligaments. The joint is painful and mildly unstable with a partial separation. A sling is used for comfort for 1-2 weeks with gradual return to normal movements relatively quickly and return to sport around 6 weeks.
  • Type 3 results in both the acromioclavicular and coracoclavicular ligaments being torn. It causes pain, swelling and deformity or ‘bump’. This type is a little controversial as to whether they require surgical intervention or not. Generally they are managed conservatively with a sling for up to 2 weeks and a slower return to activity and return to sport around 12 weeks. In some cases later surgery maybe required if pain and dysfunction persists.
  • Type 4, 5& 6 are relatively uncommon but maybe seen in car accidents where there is a severe displacement causing deformity and instability that requires surgical intervention to repair.

We wish all the cyclists in the Giro a safe and injury free tour.

Kim Garland

Symmetry Physiotherapy

 

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