AC Joint Separation Recovery Time

An AC joint separation refers to an injury to the ligaments about the AC joint that is severe enough to cause displacement or even dislocation of the AC joint.  There are 4 main grades of AC joint separation – Grade 2, Grade 3, Grade 4, and Grade 5.  As with more mild injuries the initial treatment requires ice to reduce pain and swelling as well as use of a sling for comfort.  Narcotic and/or anti-inflammatory medications will be necessary to control pain.  Careful x-ray evaluation will determine the grade of injury and after a careful discussion of risks, benefits, and alternatives you may be a candidate for surgical repair.  Non-surgical treatment begins once the initial discomfort subsides and consists of a structured rehabilitation program that begins with gentle exercises and progresses as healing allows.  Depending on the grade of injury return to full sports takes anywhere from 4 to 12 weeks.  It is advised that you contact an orthopedic surgeon if significant pain does not subside within the first month. This could potentially be an indication to either a more severe injury to the AC joint or perhaps an injury to a different part of the shoulder joint that was not initially diagnosed.  In these cases a thorough evaluation which includes additional imaging such as a CT scan or MRI may be required.


If surgery is necessary then it is necessary to use a sling for the first 6 weeks in order to counteract the force of gravity on the repair and allow initial healing of the reconstruction.  Gentle passive external rotation exercises of the shoulder begin immediately after surgery will prevent the shoulder joint itself from getting stiff during the time it is in the sling.  At the six week mark x-rays are checked and the sling is removed.  At this point range of motion exercises are initiated in order to restore shoulder motion.  No load or resistance exercises are permitted for the first for the first 3 months of recovery.  After 3 months a formal physical therapy program to restore full motion and strength can begin.  Return to most sports and activities can begin at 3 months if there has been acceptable clinical recovery progress.  It is strongly advised that activities that specifically load the AC joint such as weight lifting be avoided for the first 6 months in order to prevent any changes in the joint as the biologic connections are restored.