An acromioclavicular joint rupture is the incomplete to complete tearing of the capsular ligament apparatus of the acromioclavicular joint. Most of the time this is the result of falls where you fall directly on your shoulder.
What is a Shoulder Joint Split?
The acromioclavicular joint is called the acromioclavicular joint in technical jargon; Acromion means acromion, clavicle means collarbone. So, with a shoulder joint blast, there is an injury in the relatively small joint, which is made up of the acromion and collarbone. See bestitude for Meanings of Inner Ear Infection.
The inner part of the connection consists of the outer side of the clavicle, the outer part is the side of the acromion facing towards the center of the body. Above all, the joint is stabilized by the joint capsule and several ligaments.
In this region, the ligaments and the capsule are overstretched, strained or torn when the acromioclavicular joint is ruptured. There may also be a complete rupture of the ligaments. In the area of the shoulder girdle, the acromioclavicular joint rupture is one of the most common injuries.
Causes
The causes of an acromioclavicular joint rupture are mostly direct violence or falls on the shoulder area. Above all, this is a typical sports injury, since the arm is often pulled in front of the body when the fall occurs.
Especially in the sports of skiing, cycling, motorcycling, martial arts and horseback riding, a shoulder joint rupture is contracted. But all other types of sports that involve a lot of running can also lead to a shoulder joint rupture due to falls. A fall on an outstretched arm is less common.
Symptoms, Ailments & Signs
In the case of an existing shoulder joint rupture, severe pain in the shoulder is the clearest symptom. Affected people often also suffer from severe swelling in the shoulder region. The pain increases significantly with even the smallest of movements or when pressure is exerted. Even at rest, this pain persists. As a result, affected people usually adopt a tense, relieving posture.
The arm is bent and supported with the healthy arm. This tense position can even lead to back pain, which also gets worse as the disease progresses. If a doctor is consulted at an early stage in the case of such a shoulder joint sprain, the symptoms that occur can be alleviated quickly and effectively.
Painkillers and permanent cooling of the affected area can bring about rapid relief. The situation is different, however, if the person concerned refrains from treatment altogether. Then a significant worsening of the existing symptoms is to be expected.
In particularly bad cases, there is even permanent damage to the joint that cannot be repaired afterwards. A shoulder joint rupture is accompanied by fairly typical symptoms, which can, however, be treated very well. However, it is important to go to the doctor promptly, otherwise there is a risk of serious complications.
Diagnosis & History
In order to be able to diagnose an acromioclavicular joint rupture, a physical examination is carried out and a questioning about the exact course of the injury.
If the ligaments and/or the capsule are torn or torn, a clear misalignment of the collarbone can be seen; it stands up (it is luxated). Nevertheless, imaging diagnostics are essential in order to be able to reliably determine the acromioclavicular joint rupture.
A misalignment can be seen here, even if it is not visible from the outside. The acromioclavicular joint rupture can be divided into 3 degrees, one usually speaks of the classification according to Tossy (or Rockwood). Tossy I describes a tear in the ligaments, but the joint partners cannot be displaced. Tossy II is also an incomplete tear, but the two joint partners can be slightly displaced.
In Tossy III, the ligaments (and capsule) are completely torn and the two articulating partners are clearly movable relative to each other. The clearly protruding collarbone can be pressed down and then comes up again (piano key phenomenon).
Complications
In the case of a shoulder joint blast, those affected primarily suffer from very severe pain. These occur mainly in the shoulder, but can also spread to the surrounding regions, causing pain in the neck or arms. Patients also suffer from severe swelling and bruising.
Due to the permanent pain, many patients suffer from restricted mobility or continue to suffer from depression. Pain at night in particular can lead to irritability in the patient, which is aggravated by sleep problems. The shoulders and arms can hardly be moved because of the pain.
Movements of the hands can also lead to pain, so that the patient’s everyday life is significantly restricted. Sometimes it can happen that the ligaments are torn when the acromioclavicular joint is ruptured. However, the further course of this disease depends heavily on the exact cause and the type of accident or stroke.
In most cases, the symptoms can be limited relatively well with the help of physiotherapy. Those affected must refrain from sporting activities for a few weeks. There are no particular complications. The life expectancy of the patient is not negatively affected by the acromioclavicular joint blast as long as the accident does not endanger life.
When should you go to the doctor?
In the case of an acromioclavicular joint blast, the affected person is dependent on treatment by a doctor in any case. It cannot heal on its own, and symptoms usually get worse if left untreated. The earlier the acromioclavicular joint rupture is recognized and treated, the better the further course of this disease. A doctor should be consulted if the patient suffers from severe swelling in the shoulders.
These swellings appear for no particular reason and will not go away on their own. Severe and, above all, permanent pain in the shoulders can also indicate a shoulder joint rupture and must be examined by a doctor. The pain can also spread to the back and cause discomfort there as well. In the case of these complaints, a general practitioner or an orthopedist should always be consulted to prevent complications. The acromioclavicular joint rupture can be treated relatively well, and the life expectancy of the person affected is not restricted or reduced by the disease.
Treatment & Therapy
Once the medical treatment of the acromioclavicular joint fracture has been completed, consistent and adapted physiotherapy should be carried out in order to be able to guarantee the best possible rehabilitation. Since no surgery is necessary for Tossy I or II, light physical activity can be resumed after the pain has subsided, but this does not involve the affected shoulder.
You should not exercise at all for 1 to 2 weeks. With Tossy III, the break should be around 4-6 weeks, depending on whether the acromioclavicular joint fracture was treated conservatively or surgically. The arm should also not be spread more than 90° from the body during this period.
As an immediate measure after the fall, the arm can be stabilized on the stomach to relieve the strain, if possible with a triangular sling. A cold pack can also initially relieve the pain and reduce the swelling until you have consulted a doctor. With all 3 Tossy forms, however, physical therapy is important so that the free mobility of the arm can be restored.
Prevention
An acromioclavicular joint rupture can only be prevented to a limited extent, since these are mostly unfavorable falls on the lateral shoulder region and these cannot always be prevented. The risk of injury can only be reduced if appropriate protective clothing is worn. For example, you can wear a jacket with protective pads, especially when riding a motorcycle, as the risk of injury in the event of a fall is particularly high here. Appropriate shoulder pads can also be worn for football.
Aftercare
In the case of a shoulder joint blast, those affected primarily suffer from very severe pain. The pain occurs mainly in the shoulder, but can also spread to the neighboring regions, causing pain in the neck or arms. Patients also suffer from severe swelling and sometimes bruising.
The permanent pain can also lead to restricted mobility or depression. Nocturnal pain in particular can lead to irritability in the patient and further to sleep problems. The shoulders and arms can hardly be moved because of the pain.
Movements of the hands can also lead to pain, so that the patient’s everyday life is significantly restricted. The ligaments can also be torn in the acromioclavicular joint blast. However, the further course of this disease depends heavily on the exact cause and the type of accident or stroke.
In most cases, the symptoms can be limited relatively well with physiotherapy. Those affected must refrain from sporting activities for a few weeks. Particular complications arise. The life expectancy of the patient is not negatively affected by the acromioclavicular joint blast as long as the accident does not endanger life.
You can do that yourself
In the case of an acromioclavicular joint blast, the affected person should take it easy and avoid physical exertion if possible. Sporting activities are not to be carried out during medical treatment or should be reduced to a minimum.
Since the sick person automatically assumes a relieving posture due to the existing symptoms, there is a greater burden on other physical regions. To avoid tension or additional pain, heat treatments or massages in the affected areas are recommended. Everyday life must be restructured and adapted to the patient’s specifications and possibilities. The completion of important physical tasks should be taken over by other people so that there is no overload. The request for help must therefore be made by the patient to people from his social environment.
Physiotherapeutic therapy is part of the treatment of the acromioclavicular joint rupture. The exercises and training units learned there can also be used independently outside of the sessions. They support and promote the healing process.
Mental strength is just as important to recovery. With a positive basic attitude and optimism, the affected person helps himself to improve the overall situation more quickly. The focus of perception should not be on the activities that can no longer be carried out by oneself. It is important to recognize the help of others as well as one’s own progress within the therapy.
