ACJ in Contact Sports: Understanding Acromioclavicular Joint Injuries

In the fast-paced and demanding realm of contact sports, injuries inevitably become an integral part of the game. Athletes, driven by their passion and commitment, regularly find themselves pushing their physical boundaries to achieve peak performance. However, amid the adrenaline-fueled intensity and fierce competition, the human body can become susceptible to a range of injuries. 

One such injury that frequently emerges in the context of contact sports like AFL is the acromioclavicular joint injury, or ACJ injury, an ailment that predominantly affects the shoulder region.

As athletes give their all on the field or in the ring, they expose their bodies to forces and impacts that can sometimes lead to unexpected physical setbacks. An ACJ injury, though not uncommon, can pose significant challenges to an athlete’s performance and overall well-being. Understanding the intricacies of this type of injury is paramount, not just for athletes themselves but also for coaches, sports enthusiasts, and anyone passionate about the world of sports.

In this comprehensive guide, we will delve into the causes, symptoms, management strategies, rehabilitation, and prevention tips for ACJ injuries, shedding light on how to deal with this challenging issue.

Decoding ACJ Injuries: Causes and Symptoms in Contact 

Understanding the intricacies of ACJ injuries, including their causes and symptoms within the context of contact sports, is paramount for athletes, coaches, and sports enthusiasts. It not only aids in early detection and effective management but also plays a pivotal role in injury prevention. 

By delving into the root causes and recognising the subtle signs and symptoms, individuals can better protect themselves from the potential setbacks of an acromioclavicular joint injury.

Understanding the Anatomy of the ACJ: Key Insights

The ACJ, or acromioclavicular joint, is where the collarbone (clavicle) meets the shoulder blade (acromion). This joint plays a pivotal role in shoulder stability and movement, allowing the arm to reach overhead and perform various activities. However, the ACJ is also susceptible to injury, especially in the physically demanding realm of contact sports.

Common Causes of ACJ Injuries in Contact Sport

ACJ injuries often occur due to the high-impact nature of contact sports. Here are some common scenarios:

• Falling onto the Shoulder: Athletes can sustain ACJ injuries by falling onto their shoulder after a tackle, collision, or any abrupt impact. The force of the fall can disrupt the joint’s stability.

• Landing on the Elbow: Sometimes, during intense gameplay, a player may land on their elbow, leading to a transmission of force to the shoulder region, resulting in ACJ injury.

• Repetitive Contact: The nature of contact sports involves constant physical engagement. Repetitive contact, such as tackling in rugby or football, can gradually wear down the ACJ, leading to injury over time.

Symptoms to Watch For: Identifying ACJ Injuries

Recognising ACJ injuries early is essential for prompt treatment and recovery. Some key symptoms to watch out for include:

• Shoulder Pain: ACJ injuries often manifest as severe shoulder pain, especially when attempting movements involving the affected joint.

• Loss of Range of Motion: Injured individuals may experience a noticeable reduction in shoulder mobility, making it challenging to lift the arm or perform overhead activities.

• Shoulder Weakness: Weakness in the shoulder, particularly during activities that require strength, can be a sign of ACJ injury.

Tenderness: The ACJ area may become sensitive to touch, making activities like lying on the shoulder uncomfortable.

Sports Management of ACJ Injuries: Strategies for Recovery in Contact Sports

Management of ACJ injuries is a critical aspect of an athlete’s journey back to peak performance. The approach may vary based on the severity of the injury and the athlete’s type of sport. 

Low-grade ACJ injuries may be managed non-surgically. The steps typically involve a short period of immobilisation in which the shoulder is kept still for a brief period to allow for initial healing, followed by rest from aggravating activities that could further strain the injured joint, including contact sports.

From here, gradual rehabilitation begins with gentle range of motion exercises and light strengthening exercises. Over time, the intensity and complexity of exercises increase as tolerated.
High-grade ACJ injuries may necessitate surgical intervention. Orthopedic specialists will assess the injury’s severity and recommend surgery if needed. It’s important that you speak to your healthcare providers about the risks and benefits of surgery before committing to your decision. Oftentimes, however, a severe acromioclavicular joint injury will only see improvement through surgical means.

Returning to Sport: ACJ Injury Rehabilitation

Returning to sports post-ACJ injury is difficult because it is time-dependent on the sensitivity of the injury and the response to rehabilitation. Due to this type of injury pain can linger for long periods of time due to irritability of injury.

The general guide for return to contact sports is 4-8 weeks after passing shoulder-specific clinical markers. Physiotherapy typically commences with range of motion and strengthening exercises as tolerated. Pain should not exceed a 2-3/10 with active movements. A good sign of the healing progression is when you can comfortably lie on the affected shoulder during a night’s sleep.

These are the general phases of recovery from an acromioclavicular joint injury:

1. Early Phase:

• Sling immobilisation
• Restoring range of motion
• Graded strengthening exercises

2. Intermittent Phase:

• Gradual and progressive strengthening exercises
• Controlled contact drills
• Plyometric training
• Return to sport-specific training under guidance

3. Return to Play:

• Uncontrolled contact drills
• Full restoration of strength
• Dependent on passing clinical markers

In some contact sports, players may benefit from the use of shoulder guards, such as shoulder pads or a custom-moulded guard secured with strapping tape. These protective measures can help reduce the risk of re-injury and provide added support during gameplay.

Preventing ACJ Injuries in Contact Sports: Tips for Athletes

While injuries are an inherent risk in contact sports, there are steps athletes can take to reduce their chances of sustaining an ACJ injury:

• Proper Technique: Coaches should emphasise correct tackling and falling techniques to minimise the risk of direct shoulder impacts.

• Strength and Conditioning: Incorporating shoulder-strengthening exercises into training routines can enhance joint stability and resilience.

• Protective Gear: Wearing appropriate protective gear, such as shoulder pads and well-fitted helmets, can offer an extra layer of protection during gameplay.

• Regular Check-ups: Athletes should undergo regular physical assessments to identify any underlying issues that could predispose them to ACJ injuries.

• Rest and Recovery: Adequate rest and recovery between matches or training sessions are crucial for maintaining optimal physical condition and minimising the risk of overuse injuries.

In the world of contact sports, injuries like ACJ injuries are a common challenge. However, armed with knowledge about the causes, symptoms, management, rehabilitation, and prevention, athletes can better navigate their way through these setbacks. Whether you’re a seasoned player or a passionate sports enthusiast, understanding ACJ injuries is a step towards safer and more enjoyable gameplay. 
If you suspect an ACJ injury, consult with a healthcare professional or contact our expert team at Coast Sport for an accurate diagnosis and personalised treatment plan, ensuring a swift and successful return to the field.