What are the treatment options for AC joint injury?

The acromioclavicular joint sits at the top of the shoulder where the collarbone meets the shoulder blade. A fall or direct blow can stretch or tear its supporting ligaments. The degree of separation, pain, shoulder stability, arm use and physical demands all influence treatment. A clinical examination and shoulder X-ray may help define the injury.

Many injuries are initially managed without surgery. A sling or other support can reduce painful movement while the tissues settle. [Splinting](/treatments/trauma-and-fracture-care/splinting/) is one form of support, although the exact device and duration should be selected for the shoulder injury.

Early care may include relative rest, ice wrapped in a cloth, suitable pain relief and avoiding lifting or reaching that increases symptoms. As pain allows, [Physiotherapy](/treatments/physiotherapy-and-rehabilitation/physiotherapy/) can restore shoulder motion, strength and control. Surgery may be discussed when the joint remains significantly unstable, the injury is severe, or shoulder demands make the deformity and weakness difficult to manage. A procedure such as [Fracture Fixation Surgery](/treatments/trauma-and-fracture-care/fracture-fixation-surgery/) is considered only after an orthopaedic assessment of the specific injury.

Seek prompt assessment after a shoulder impact if the collarbone appears displaced, the skin is being stretched, pain is severe, or you cannot use the arm. Get urgent help for a cold, pale or numb hand, rapidly increasing swelling, or an open wound near the joint.

How stable is my AC joint? Do I need a sling or other support, and for how long? When should shoulder exercises begin? What findings would make surgery worth considering for my work or sport?