Acromioclavicular Joint Injury

acromioclavicular joint injury

What’s up ? This is THE stephane ANDRE. With my training, I’m interested in biomechanics to avoid injuries. I read « Sport Medicine Media Guide » and I learned some good stuff.

Acromioclavicular joint is a joint between the clavicle and the scapula. Acromion is a continuation of the scapular spine and hooks over anteriorly. It articulate with the clavicle (collar bone ) to form the acromioclavicular joint.

Problems types

The most common problems are arthritis, fracture and separation. Arthritis is characterized by a loss of joint’s cartilage. Arthritis of acromioclavicular joint is common with weight lifter, especially with bench press and a little less with shoulder press. When there is a problem with the rotator cuff, it’s possible that there is also acromioclavicular joint’s arthritis.

Acromioclavicular separation

acromioclavicular joint injury type grade

When there is an acromioclavicular joint separation, it means that the ligament that connects the acromion and clavicle is damaged and that the 2 structures don’t align properly. Separation’s state can be weak or severe, that is why there is a system of « grade » according to which ligament is torn and the severity of the tear.

Grade I Injury – This is the weakest damage and the acromioclavicular joint is still aligned.

Grade II Injury – This is an average damage. Ligaments are only stretched but not fully torn. In case of stress (physical effort), the acromioclavicular joint becomes painful and unstable.

Grade III Inury – This is a serious damage. Ligaments are completely torn and the collar bone is no longer attached to the scapula, which creates a visible deformity.

Treatment of acromioclavicular joint arthritis

If the rest, ice, medications and change of the training program (changing the exercises) don’t work, the next step is a shot of cortisone. A shot of cortisone in the joint may have calmed the pain and may be permanently swollen. As each individual is unique, the effects may vary and it’s possible that it doesn’t swell permanently.

If non-surgical methods fail, it’s possible to perform a surgical operation. The pain is localized at the bones end that make contact with each other and the goal of the operation is to remove some of the end of the clavicle. This ambulatory surgery can be done with a small incision of 1 inch (2.5 cm) long or with the arthroscopy technique with 2-3 incisions. The results and recovery of these 2 surgical techniques are about the same. Most patients have a full movement by 6 weeks and can return to do sport by 12 weeks.

Treatment for acromioclavicular separation

Separation can create very painful injuries, so the first thing to do is to decrease the pain. Hold the arm in a sling, put ice and pack the shoulder for 20-30 minutes every 2 hours as needed. Acetaminophen and non-steroidal anti-inflammatory medications can also help calm the pain.

When the pain begins to subside, it’s important to move the fingers, wrists and elbow (and eventually the shoulders) in order to avoid having stiff or « frozen » shoulder. The length of time needed to regain complete movement and function depends on the severity or injury’s grade.

Recovery from Grade I acromioclavicular separation usually takes 10-14 days while Grade III takes 6-8 weeks.

When surgery

Grade I and II separations require very rarely surgery. With a Grade III injury, after surgery, it’s possible to have full body physical activity with some restrictions.

Statistics

  • More males than females suffer acromioclavicular joint injuries

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-Steph

Ankle Sprain

ankle sprain inversion lateral

What’s up ? This is THE stephane ANDRE. With my training, I’m interested in biomechanics to avoid injuries. I read « Sport Medicine Media Guide » and I learned some good stuff.

A sprain is a stretch injury of the ligament that supports the ankle. This sprain often happens to the ligament outside the ankle when the foot is twisted inward (inverted). It’s a « lateral » ankle sprain that localized to the ligaments in the outer/lower part of the ankle.

A « high » ankle sprain (or syndesmosis injury) is a ligament stretch injury that holds the tibia and fibula together in the lower leg. This type of sprain happens when the ankle is twisted outward, it’s an eversion injury.

ankle sprain inversion eversion syndesmatic lateral medial high

When there is a sprain, the ankle is tender and swollen on the outside, above and at the front of the ankle bone, but the pain doesn’t come from the ankle bone. A sprain can create moderate or severe pain that can prevent the foot from supporting the body weight.

ankle sprain stretch injury grade

Treatment of sprained ankle

ankle sprain rice rest ice compression elevation

The basic treatment is what we call RICE (rest, ice, compression and elevation). During a severe sprain, it’s advisable to use a walking boot to help support the ankle.

Recovery time for a « lateral » sprain is usually 1-3 weeks and for a « high » sprain is usually 3-6 weeks.

Rehabilitation can begin a few days after the sprain when swelling decreases. The rheabilitation has 3 goals :

  1. Restore movement and flexibility

  2. Restore strength

  3. Restore balance

How to avoid a ankle sprain

It’s possible to use a brace to help prevent sprains. There are several types of neoprene or elastic materials. Here are some models on Amazon, click here .

Statistics

  • Ankle sprains are more common in all sport that involve cutting and pivoting

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-Steph

Acromioclavicular Problems

acrominioclavicular problem

I read a Frederic Delavier’s book « Strength Training Anatomy » and there is good stuff.

Frequent bodybuilding’s athletes are often confronted with acromioclavicular diseases.

This doesn’t happen in the same way as with sports like rugby, football, riding or combat sport with projections where the shoulder joint can be damaged by a fall or violent contact which leads to acromioclavicular dislocation with a ligament tear.

In bodybuilding, it’s micotraumatism caused by excessive, repetitive and poorly controlled work of the shoulder joint.

The pain happens little by little and after a while, pain prevents doing exercises like bench press or dips.

When doctors examine the acromioclavicular joint, it’s painful to pressure and slightly swollen.

It’s a problem without real gravity but the cure is long. The joint capsule and ligaments stretched because of inflammation, which give play to the joint. It takes some times for the entire articulation to return to its inital size.

Firstly, it’s necessary to stop the upper body training for 2 weeks

Note : from a bone view’s point, the upper limb connected to the bust by the clavicle which goes from the sternum to the scapla. In bodybuilding workouts, clavicular joints are often over-solicited and this create inflammatory pathologies of wear and tear.

Back to train

When upper body workout starts again, it’s necessary not to do bench press, dips and all movements with pushed down for at least 2 months. This is important to avoid re-stretching acromioclavicular ligaments.

Military press with barbell/dumbbell, inclined bench press and all movements with pusched up are allowed as they stabilize acromioclavicular joint. These movements limit the risk of ligament stretching.

If these tips aren’t respected. The joint inflammation will continue causing intra-articular calcifications and seriously compromising a sport career.

acrominioclavicular problem

Prevention :

These acromio-calvicular inflammations often occur after excessive training with the bench press due to a poorly controlled movements, with a too rapid descent, rebounding on the torso, sets too long and jerky.

The bench press in powerlifter’s style can also trigger inflammatory pathologies.

It’s for this reason that, at the least suspicious pain, it’s necessary to stop these movements for a time and to replace them by cable chest fly, dumbbells movement with a certain inclinaison of the bench for continue working chest.

Share this articles if you think it can help someone you know. Thank you.

-Steph